Is ICD-10-CM code Z93 billable?

No, Z93 (Artificial opening status) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code Z93 belong to?

Z93 belongs to Chapter 21 of the ICD-10-CM tabular list: Z00–Z99 (Factors Influencing Health Status and Contact with Health Services).

Z93Not billable, use a more specific code below

Artificial opening status

In Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99), chapter 21: Factors Influencing Health Status and Contact with Health Services

12 billable codes under Z93: none are a CC or MCC; all map to HCC 463 (Artificial Openings for Feeding or Elimination), HCC 211 (Respirator Dependence/Tracheostomy Status/Complications).An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

artificial openings requiring attention or management (Z43.-)
complications of external stoma (J95.0-, K94.-, N99.5-)

Also applies, from Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)

These notes sit on Z77-Z99 and apply to every code under it, including Z93.

Code also: add a code for this too, order depends on the encounter

any follow-up examination (Z08-Z09)

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Covers when and how to use Z codes (Z00-Z99) for encounters and supplementary information, including contact, status, history, screening, aftercare, exams, and social determinants of health.

Use of Z Codes in Any Healthcare Setting (page 92)
Z Codes Indicate a Reason for an Encounter or Provide Additional Information about a Patient Encounter (page 93)
Categories of Z Codes (page 93)

Read Section I.C.21 (page 92)

All codes under Z93

Z93 can't be used on a claim. Pick a billable code below; grey headings group them.

Z93 MS-DRGs

As the principal diagnosis, the billable codes under Z93 group to MS-DRG 951, 698, 699, or 700 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 951 Other Factors Influencing Health Status (12 of 12 codes)
DRG 698 Other Kidney and Urinary Tract Diagnoses with MCC (1 of 12 codes)
DRG 699 Other Kidney and Urinary Tract Diagnoses with CC (1 of 12 codes)
DRG 700 Other Kidney and Urinary Tract Diagnoses without CC/MCC (1 of 12 codes)

Other codes that refer to Z93

Notes on these codes point to Z93.

L24.B Use Additional Code: code to identify any artificial opening status (Z93.-), if applicable, for contact dermatitis related to stoma secretions
T80-T88 Excludes2: artificial opening status (Z93.-)
Z43.1 Excludes2: artificial opening status only, without need for care (Z93.-)
Z78 Excludes2: postprocedural status (Z93-Z99)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Ostomy

An ostomy is surgery to create an opening (stoma) from an area inside the body to the outside. It treats certain diseases of the digestive or urinary systems. It can be permanent, when an organ must be removed. It can be temporary, when the organ needs time to heal. The organ could be the small intestine, colon, rectum, or bladder. With an ostomy, there must be a new way for wastes to leave the body.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.