Underdosing and Noncompliance of Medication ICD-10-CM Coding


In this comprehensive course, participants will gain a deep understanding of underdosing and noncompliance in the context of ICD-10-CM coding for medications. Coders often grapple with the concept of "underdosing" and its implications in medical coding. This course is designed to demystify underdosing, equip coders with the necessary knowledge to assign accurate ICD-10-CM codes, and shed light on the relationship between underdosing and noncompliance.

Included Lessons:

  • Introduction to Underdosing and Noncompliance
  • Underdosing
  • Noncompliance
  • Assigning ICD-10-CM Codes for Underdosing and Noncompliance
  • General Underdosing Rules and Application of 7th Characters - ICD-10-CM Official Guidelines for Coding and Reporting
CEUs available for the following credentials:




Key Takeaways

This course will provide coders, healthcare professionals, and medical billing personnel with the knowledge and skills needed to accurately assign ICD-10-CM codes for underdosing and noncompliance, ultimately improving coding accuracy and facilitating better patient care management. Some key takeaways from this course are:

  • Definition of Underdosing: Participants will grasp the concept of underdosing, which refers to taking less medication than prescribed or directed by a healthcare provider or manufacturer's instructions. They will understand what constitutes underdosing, including dose reduction, complete discontinuation, and exceptions.
  • Significance of Underdosing Codes: Recognizing the importance of underdosing codes in identifying the causes of readmissions, especially for patients with chronic conditions that can be managed with medications. Participants will understand how underdosing codes contribute to tracking and managing hospital readmission rates.
  • Underdosing as a Complication: Understanding how underdosing can be a complication of care, such as when it results from mechanical issues with medical devices. Participants will learn when and how to code underdosing in such scenarios.
  • Noncompliance Codes: Participants will be introduced to specific noncompliance codes that capture the reasons behind underdosing. This includes intentional and unintentional noncompliance due to factors like financial hardship or age-related debility.
  • Coding Steps: Learning a systematic approach to coding underdosing, including referencing the Table of Drugs and Chemicals, applying the 7th character when necessary, and sequencing codes correctly based on the patient's condition and the cause of underdosing.
  • Guidelines and Excerpts: Familiarity with key guidelines from the ICD-10-CM Official Guidelines for Coding and Reporting, including the importance of using the Tabular List, not coding directly from the Table of Drugs, and assigning multiple codes as needed.
  • Practical Examples: Participants will analyze practical coding scenarios to reinforce their understanding and application of underdosing and noncompliance codes in real-world healthcare situations.
  • Miscellaneous Z Codes: Exploration of miscellaneous Z codes, with a focus on Z91.1, which signifies a patient's noncompliance with medical treatment and regimen. These codes provide additional context for patient care and treatment.
  • Enhanced Coding Accuracy: The course equips participants with the knowledge and skills needed to accurately assign ICD-10-CM codes for underdosing and noncompliance, which can lead to improved coding accuracy and better patient care management.
  • Quality Healthcare Management: Understanding underdosing and noncompliance codes is crucial for healthcare facilities aiming to track and manage patient outcomes effectively, especially for conditions like heart failure, pneumonia, and other chronic illnesses

Benefits of Taking this Course

  • Enhanced Coding Skills
  • Improved Coding Accuracy
  • Improved Documentation
  • Increased Confidence 
  • Continued Professional Development


What is the difference between underdosing and noncompliance in ICD-10-CM coding?

Underdosing refers to taking less medication than prescribed or directed by a healthcare provider or manufacturer's instructions. Noncompliance, on the other hand, encompasses both intentional and unintentional reasons behind underdosing, such as financial hardship or age-related debility. Noncompliance codes provide insight into why underdosing occurs.

When should underdosing codes be used, and can they be assigned as principal diagnosis codes?

Underdosing codes (categories T36-T50 with fifth or sixth character "6") should never be assigned as principal or first-listed diagnosis codes. Instead, they are used to describe instances where underdosing of medication has occurred in addition to coding for the patient's medical condition. Underdosing codes help capture the cause of readmissions or complications.

Are there specific guidelines for coding noncompliance with medication regimens due to external factors like cost or internal factors like age-related debility?

Yes, ICD-10-CM has introduced more specific noncompliance codes that capture the reasons behind underdosing, including intentional noncompliance due to financial hardship and unintentional noncompliance due to factors like age-related debility. These codes provide additional context for coding and reporting.

About our Medical Coding Courses

HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a comprehensive online education platform for medical coders. With a catalog of over 200 medical coding courses accepted by the American Health Information Management Association (AHIMA) for Continuing Education Units (CEUs) and a selection approved by the American Academy of Professional Coders (AAPC), HIAlearn caters to both beginners and experienced medical coders seeking to enhance their skills. The platform provides an array of training plans tailored to meet individual learning needs, from mastering challenging coding procedures to understanding broad conceptual frameworks within the coding world. Courses are available across various coding types including CPTE/M, ICD-10-CMICD-10-PCS, and are designed to cater to different coder levels and coding specialties such as inpatientoutpatientprofee, and CDI. Additionally, HIAlearn offers a Coding Updates bundle to ensure coders are up-to-date with the annual changes in ICD-10-CMICD-10-PCSCPT, and IPPS. Beyond individual learning, HIAlearn supports organizations with group discounts, promoting enhanced coding accuracy, efficiency, and compliance across teams. 

Price : $35.99
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