Z60.4Social exclusion and rejection

Z60.4 is the ICD-10-CM diagnosis code for social exclusion and rejection. It belongs to category Z60 (problems related to social environment), block Z55-Z65 (persons with potential health hazards related to socioeconomic and psychosocial circumstances) and chapter 21 (factors influencing health status and contact with health services). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within Z60 (problems related to social environment), Z60.4 is specifically for social exclusion and rejection. Related codes cover problems of adjustment to life-cycle transitions (Z60.0), problems related to living alone (Z60.2), Acculturation difficulty (Z60.3), target of (perceived) adverse discrimination and persecution (Z60.5), other problems related to social environment (Z60.8) and problem related to social environment, unspecified (Z60.9).

Don't report Z60.4 together with the conditions in its Excludes1 note: target of adverse discrimination such as for racial or religious reasons (Z60.5).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 951 (Other Factors Influencing Health Status, relative weight 0.5577), in MDC 23 (Factors Influencing Health Status and Other Contacts with Health Services), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is not acceptable as the principal diagnosis for an inpatient stay; it may be reported as a secondary diagnosis.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as V62.4 (social maladjustment).