What Are V Codes and Z Codes in a Diagnosis?

If you’ve sought mental health support for a child, you might have seen a note in their diagnosis or medical record about specific challenges they’re dealing with. For example, “V61.8 – Sibling Relational Problem” or “Z63.7 – Ill family member.” These codes are often called V codes or Z codes. They are not mental health disorders, but they can still be an important factor in the child’s treatment.

V codes and Z codes give clinicians a way of noting situations that might be stressful for a child and have a negative impact on their mental health. They indicate that a child might need support to deal with that event or challenge.

V codes and Z codes are not just for children. Clinicians may use these codes with adolescents and adults too, and they can be helpful for patients of all ages.

V codes come from two clinical guides, the DSM-5 and the ICD-9. Z codes come from a more recently updated guide, the ICD -10. But V codes and Z codes work the same way in a diagnosis, and both are still widely used.

Sometimes you’ll see a V or Z code alongside a diagnosis of a mental health disorder. Other times, a clinician might use a code in the record of a child who doesn’t have a mental health diagnosis. The idea is that mental health support can be helpful for kids in specific stressful situations, whether or not they have a diagnosis.

Here are a few ways that V and Z codes can be useful in mental health treatment:

• They help kids without diagnosable disorders get support. For instance, a child who is dealing with a death in the family or a stressful situation (switching schools, moving, parents’ divorce) might need help coping with change and processing their emotions. V and Z codes help kids in hard situations get support without the stigma or complication of an unnecessary diagnosis.
• They alert other professionals to important issues. When a child’s diagnosis includes a V or Z code, it lets other people who see the diagnosis — pediatricians, teachers, clinicians the child sees in the future — know to pay attention to that specific challenge in the child’s life.
• They emphasize the importance of kids’ social and environmental contexts. Often, children’s emotional and behavioral challenges stem in large part from their surroundings. By using a V or Z code, clinicians can highlight the importance of specific factors in the child’s life at home, at school or in their community.