V Codes (DSM-5) & Z Codes (ICD-10)

V Codes (in the DSM-5 and ICD-9) and Z Codes (in the ICD-10), also known as Other Conditions That May Be a Focus of Clinical Attention, addresses issues that are a focus of clinical attention or affect the diagnosis, course, prognosis, or treatment of a patient's mental disorder. However, these codes are not mental disorders.

It is often helpful to put a code in a patient's clinical documentation when there is no evidence of a mental disorder, but they are presenting with significant clinical distress. Compared to DSM-5 V Codes, ICD-10 Z Codes are much more comprehensive and cover a wider variety of psychosocial problems.

Relational Problems

V61.20 (Z62.820) Parent-Child Relational Problem
V61.8 (Z62.891) Sibling Relational Problem
V61.8 (Z62.29) Upbringing Away From Parents
V61.29 (Z62.898) Child Affected by Parental Relationship Distress
V61.10 (Z63.0) Relationship Distress With Spouse or Intimate Partner
V61.03 (Z63.5) Disruption of Family by Separation or Divorce
V61.8 (Z63.8) High Expressed Emotion Level Within Family
V62.82 (Z63.4) Uncomplicated Bereavement

Educational and Occupational Problems

V62.3 (Z55.9) Academic or Educational Problem
V62.21 (Z56.82) Problem Related to Current Military Deployment Status
V62.29 (Z56.9) Other Problem Related to Employment

Housing and Economic Problems

V60.0 (Z59.0) Homelessness
V60.1 (Z59.1) Inadequate Housing
V60.89 (Z59.2) Discord With Neighbor, Lodger, or Landlord
V60.6 (Z59.3) Problem Related to Living in a Residential Institution
V60.2 (Z59.4) Lack of Adequate Food or Safe Drinking Water
V60.2 (Z59.5) Extreme Poverty
V60.2 (Z59.6) Low Income
V60.2 (Z59.7) Insufficient Social Insurance or Welfare Support
V60.9 (Z59.9) Unspecified Housing or Economic Problem

Other Problems Related to the Social Environment

V62.89 (Z60.0) Phase of Life Problem
V60.3 (Z60.2) Problem Related to Living Alone
V62.4 (Z60.3) Acculturation Difficulty
V62.4 (Z60.4) Social Exclusion or Rejection
V62.4 (Z60.5) Target of (Perceived) Adverse Discrimination or Persecution
V62.9 (Z60.9) Unspecified Problem Related to Social Environment

Problems Related to Crime or Interaction With the Legal System

V62.89 (Z65.4) Victim of Crime
V62.5 (Z65.0) Conviction in Civil or Criminal Proceedings Without Imprisonment
V62.5 (Z65.1) Imprisonment or Other Incarceration
V62.5 (Z65.2) Problems Related to Release From Prison
V62.5 (Z65.3) Problems Related to Other Legal Circumstances

Other Health Service Encounters for Counseling and Medical Advice

V65.49 (Z70.9)  Sex Counseling
V65.40 (Z71.9)  Other Counseling or Consultation

Problems Related to Other Psychosocial, Personal, and Environmental Circumstances

V62.89 (Z65.8) Religious or Spiritual Problem
V61.7 (Z64.0) Problems Related to Unwanted Pregnancy
V61.5 (Z64.1) Problems Related to Multiparity
V62.89 (Z64.4) Discord With Social Service Provider, Including Probation Officer, Case Manager, or Social Services Worker
V62.89 (Z65.4) Victim of Terrorism or Torture
V62.22 (Z65.5) Exposure to Disaster, War, or Other Hostilities
V62.89 (Z65.8) Other Problem Related to Psychosocial Circumstances
V62.9 (Z65.9) Unspecified Problem Related to Unspecified Psychosocial Circumstances

Other Circumstances of Personal History

V15.49 (Z91.49) Other Personal History of Psychological Trauma
V15.59 (Z91.5) Personal History of Self-Harm
V62.22 (Z91.82) Personal History of Military Deployment
V15.89 (Z91.89) Other Personal Risk Factors
V69.9 (Z72.9) Problem Related to Lifestyle
V71.01 (Z72.811) Adult Antisocial Behavior
V71.02 (Z72.810) Child or Adolescent Antisocial Behavior
V63.9 (Z75.3) Unavailability or Inaccessibility of Health Care Facilities
V63.8 (Z75.4) Unavailability or Inaccessibility of Other Helping Agencies
V15.81 (Z91.19) Nonadherence to Medical Treatment
278.00 (E66.9) Overweight or Obesity
V65.2 (Z76.5) Malingering
V40.31 (Z91.83) Wandering Associated With a Mental Disorder
V62.89 (R41.83) Borderline Intellectual Functioning

Abuse and Neglect

995.54 (T74.12XA) Child Physical Abuse, Confirmed
995.54 (T76.12XA) Child Physical Abuse, Suspected
V61.21 (Z69.010) Encounter for mental health services for victim of child abuse by parent
V61.21 (Z69.020) Encounter for mental health services for victim of nonparental child abuse
V15.41 (Z62.810) Personal history (past history) of physical abuse in childhood
V61.22 (Z69.011) Encounter for mental health services for perpetrator of parental child abuse
V62.83 (Z69.021) Encounter for mental health services for perpetrator of nonparental child abuse
V61.21 (Z69.010) Encounter for mental health services for victim of child sexual abuse by parent
V61.21 (Z69.020) Encounter for mental health services for victim of nonparental child sexual abuse
V15.41 (Z62.810) Personal history (past history) of sexual abuse in childhood
V61.22 (Z69.011) Encounter for mental health services for perpetrator of parental child sexual abuse
V62.83 (Z69.021) Encounter for mental health services for perpetrator of nonparental child sexual abuse
995.52 (T74.02XA) Child Neglect, Confirmed
995.52 (T76.02XA) Child Neglect, Suspected
V61.21 (Z69.010) Encounter for mental health services for victim of child neglect by parent
V61.21 (Z69.020) Encounter for mental health services for victim of nonparental child neglect
V15.42 (Z62.812) Personal history (past history) of neglect in childhood
V61.22 (Z69.011) Encounter for mental health services for perpetrator of parental child neglect
V62.83 (Z69.021) Encounter for mental health services for perpetrator of nonparental child neglect
995.51 (T74.32XA) Child Psychological Abuse, Confirmed
995.51 (T76.32XA) Child Psychological Abuse, Suspected
V61.21 (Z69.010) Encounter for mental health services for victim of child psychological abuse by parent
V61.21 (Z69.020) Encounter for mental health services for victim of nonparental child psychological abuse
V15.42 (Z62.811) Personal history (past history) of psychological abuse in childhood
V61.22 (Z69.011) Encounter for mental health services for perpetrator of parental child psychological abuse
V62.83 (Z69.021) Encounter for mental health services for perpetrator of nonparental child psychological abuse
995.81 (T74.11XA) Spouse or Partner Violence, Physical, Confirmed
995.81 (T76.11XA) Spouse or Partner Violence, Physical, Suspected
V61.11 (Z69.11) Encounter for mental health services for victim of spouse or partner violence, physical
V15.41 (Z91.410) Personal history (past history) of spouse or partner violence, physical
V61.12 (Z69.12) Encounter for mental health services for perpetrator of spouse or partner violence, physical
995.83 (T74.21XA) Spouse or Partner Violence, Sexual, Confirmed
995.83 (T76.21XA) Spouse or Partner Violence, Sexual, Suspected
V61.11 (Z69.81) Encounter for mental health services for victim of spouse or partner violence, sexual
V15.41 (Z91.410) Personal history (past history) of spouse or partner violence, sexual
V61.12 (Z69.12) Encounter for mental health services for perpetrator of spouse or partner violence, sexual
995.85 (T74.01XA) Spouse or Partner Neglect, Confirmed
995.85 (T76.01XA) Spouse or Partner Neglect, Suspected
V61.11 (Z69.11) Encounter for mental health services for victim of spouse or partner neglect
V15.42 (Z91.412) Personal history (past history) of spouse or partner neglect
V61.12 (Z69.12) Encounter for mental health services for perpetrator of spouse or partner neglect
995.82 (T74.31XA) Spouse or Partner Abuse, Psychological, Confirmed
995.82 (T76.31XA) Spouse or Partner Abuse, Psychological, Suspected
V61.11 (Z69.11) Encounter for mental health services for victim of spouse or partner psychological abuse
V15.42 (Z91.411) Personal history (past history) of spouse or partner psychological abuse
V61.12 (Z69.12) Encounter for mental health services for perpetrator of spouse or partner psychological abuse
995.81 (T74.11XA) Adult Physical Abuse by Nonspouse or Nonpartner, Confirmed
995.81 (T76.11XA) Adult Physical Abuse by Nonspouse or Nonpartner, Suspected
V65.49 (Z69.81) Encounter for mental health services for victim of nonspousal or nonpartner adult abuse
V62.83 (Z69.82) Encounter for mental health services for perpetrator of nonspousal or nonpartner adult abuse

This list is not comprehensive!

The ICD-10 online manual has a much more comprehensive list of all the V codes that can be used. The list below contains the commonly used codes in behavioural and mental health.

Problems Related to Education and Literacy (Z55)

Z55.0 Illiteracy and low-level literacy
Z55.1 Schooling unavailable and unattainable
Z55.2 Failed examinations
Z55.3 Underachievement in school
Z55.4 Educational maladjustment and discord with teachers and classmates
Z55.8 Other problems related to education and literacy
Z55.9 Problem related to education and literacy, unspecified

Problems Related to Employment and Unemployment (Z56)

Z56.0 Unemployment, unspecified
Z56.1 Change of job
Z56.2 Threat of job loss
Z56.3 Stressful work schedule
Z56.4 Discord with boss and workmates
Z56.5 Uncongenial work
Difficult conditions at work
Z56.6 Other physical and mental strain related to work
Z56.7 Other and unspecified problems related to employment

Problems Related to Housing and Economic Circumstances (Z59)

Z59.0 Homelessness
Z59.1 Inadequate housing
Lack of heating
Restriction of space
Technical defects in home preventing adequate care
Unsatisfactory surroundings
Z59.2 Discord with neighbours, lodgers and landlord
Z59.3 Problems related to living in residential institution
Boarding-school resident
Z59.4 Lack of adequate food
Z59.5 Extreme poverty
Z59.6 Low income
Z59.7 Insufficient social insurance and welfare support
Z59.8 Other problems related to housing and economic circumstances
Foreclosure on loan
Isolated dwelling
Problems with creditors
Z59.9 Problem related to housing and economic circumstances, unspecified

Problems Related to Social Environment (Z60)

Z60.0 Problems of adjustment to life-cycle transitions
Adjustment to retirement [pension]
Empty nest syndrome
Z60.1 Atypical parenting situation
Problems related to a parenting situation (rearing of children) with a single parent or other than that of two cohabiting biological parents.
Z60.2 Living alone
Z60.3 Acculturation difficulty
Migration
Social transplantation
Z60.4 Social exclusion and rejection
Exclusion and rejection on the basis of personal characteristics, such as unusual physical appearance, illness or behaviour.
Z60.5 Target of perceived adverse discrimination and persecution
Persecution or discrimination, perceived or real, on the basis of membership of some group (as defined by skin colour, religion, ethnic origin, etc.) rather than personal characteristics.
Z60.8 Other problems related to social environment
Z60.9 Problem related to social environment, unspecified

Problems Related to Negative Life Events in Childhood (Z61)

Z61.0 Loss of love relationship in childhood
Z61.1 Removal from home in childhood
Z61.2 Altered pattern of family relationships in childhood
Z61.3 Events resulting in loss of self-esteem in childhood
Z61.4 Problems related to alleged sexual abuse of child by person within primary support group
Z61.5 Problems related to alleged sexual abuse of child by person outside primary support group
Z61.6 Problems related to alleged physical abuse of child
Z61.7 Personal frightening experience in childhood
Z61.8 Other negative life events in childhood
Z61.9 Negative life event in childhood, unspecified

Other Problems Related to Upbringing (Z62)

Z62.0 Inadequate parental supervision and control
Z62.1 Parental overprotection
Z62.2 Institutional upbringing
Z62.3 Hostility towards and scapegoating of child
Z62.4 Emotional neglect of child
Z62.5 Other problems related to neglect in upbringing
Z62.6 Inappropriate parental pressure and other abnormal qualities of upbringing
Z62.8 Other specified problems related to upbringing
Z62.9 Problem related to upbringing, unspecified

Other Problems Related to Primary Support Group, including family circumstances (Z63)

Z63.0 Problems in relationship with spouse or partner
Discord between partners resulting in severe or prolonged loss of control, in generalization of hostile or critical feelings or in a persisting atmosphere of severe interpersonal violence (hitting or striking).
Z63.1 Problems in relationship with parents and in-laws
Z63.2 Inadequate family support
Z63.3 Absence of family member
Z63.4 Disappearance and death of family member
Assumed death of family member
Z63.5 Disruption of family by separation and divorce
Estrangement
Z63.6 Dependent relative needing care at home
Z63.7 Other stressful life events affecting family and household
Anxiety (normal) about sick person in family
Health problems within family
Ill or disturbed family member
Isolated family
Z63.8 Other specified problems related to primary support group
Family discord NOS
High expressed emotional level within family
Inadequate or distorted communication within family
Z63.9 Problem related to primary support group, unspecified

Problems related to certain psychosocial circumstances (Z64)

Z64.0 Problems related to unwanted pregnancy
Z64.1 Problems related to multiparity
Z64.2 Seeking and accepting physical, nutritional and chemical interventions known to be hazardous and harmful
Z64.3 Seeking and accepting behavioural and psychological interventions known to be hazardous and harmful
Z64.4 Discord with counsellors
Discord with: probation officer or social worker

Problems Related to Other Psychosocial Circumstances (Z65)

Z65.0 Conviction in civil and criminal proceedings without imprisonment
Z65.1 Imprisonment and other incarceration
Z65.2 Problems related to release from prison
Z65.3 Problems related to other legal circumstances
Arrest
Child custody or support proceedings
Litigation
Prosecution
Z65.4 Victim of crime and terrorism
Victim of torture
Z65.5 Exposure to disaster, war and other hostilities
Z65.8 Other specified problems related to psychosocial circumstances
Z65.9 Problem related to unspecified psychosocial circumstances