Is ICD-10-CM code Z97 billable?

No, Z97 (Presence of other devices) 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 Z97 belong to?

Z97 belongs to Chapter 21 of the ICD-10-CM tabular list: Z00–Z99 (Factors Influencing Health Status and Contact with Health Services).

Z97Not billable, use a more specific code below

Presence of other devices

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 Z97: none are a CC or MCC; 3 map to HCC 409 (Amputation Status, Lower Limb/Amputation Complications).An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

complications of internal prosthetic devices, implants and grafts (T82-T85)

Excludes2: not included here, code separately if applicable

fitting and adjustment of prosthetic and other devices (Z44-Z46)
presence of cerebrospinal fluid drainage device (Z98.2)

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 Z97.

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 Z97

Z97 can't be used on a claim. Pick a billable code below; grey headings group them.

Z97 MS-DRGs

As the principal diagnosis, the billable codes under Z97 group to MS-DRG 564, 565, 566, 951, 124, or 125 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 564 Other Musculoskeletal System and Connective Tissue Diagnoses with MCC (7 of 13 codes)
DRG 565 Other Musculoskeletal System and Connective Tissue Diagnoses with CC (7 of 13 codes)
DRG 566 Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCC (7 of 13 codes)
DRG 951 Other Factors Influencing Health Status (5 of 13 codes)
DRG 124 Other Disorders of the Eye with MCC or Thrombolytic Agent (1 of 13 codes)
DRG 125 Other Disorders of the Eye without MCC (1 of 13 codes)

Other codes that refer to Z97

Notes on these codes point to Z97.

M96 Excludes2: presence of functional implants and other devices (Z96-Z97)
Z18 Excludes1: organ or tissue replaced by means other than transplant (Z96.-, Z97.-)
Z44 Excludes1: presence of prosthetic device (Z97.-)
Z45.018 Excludes2: presence of prosthetic and other devices (Z95.1-Z95.5, Z95.811-Z97)
Z46 Excludes2: presence of prosthetic and other devices (Z95-Z97)
Z87.7 Excludes2: presence of other devices (Z97.-)

Code history

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