Is ICD-10-CM code Z95 billable?

No, Z95 (Presence of cardiac and vascular implants and grafts) 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 Z95 belong to?

Z95 belongs to Chapter 21 of the ICD-10-CM tabular list: Z00–Z99 (Factors Influencing Health Status and Contact with Health Services).

Z95Not billable, use a more specific code below

Presence of cardiac and vascular implants and grafts

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

13 billable codes under Z95: 2 are a CC; 2 map to HCC 223 (Heart Failure with Heart Assist Device/Artificial Heart).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes2: not included here, code separately if applicable

complications of cardiac and vascular devices, implants and grafts (T82.-)

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 Z95.

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 Z95

Z95 can't be used on a claim. Pick a billable code below; grey headings group them.

Z95 MS-DRGs

As the principal diagnosis, the billable codes under Z95 group to MS-DRG 314, 315, 316, or 951 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 314 Other Circulatory System Diagnoses with MCC (7 of 13 codes)
DRG 315 Other Circulatory System Diagnoses with CC (7 of 13 codes)
DRG 316 Other Circulatory System Diagnoses without CC/MCC (7 of 13 codes)
DRG 951 Other Factors Influencing Health Status (6 of 13 codes)

Other codes that refer to Z95

Notes on these codes point to Z95.

Z18 Excludes1: in situ cardiac device (Z95.-)
Z46 Excludes2: presence of prosthetic and other devices (Z95-Z97)
Z87.7 Excludes2: presence of cardiac and vascular implants and grafts (Z95.-)
Z94 Excludes2: presence of vascular grafts (Z95.-)

Code history

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