Implants, Devices, and Ostomy Status ICD-10-CM codes

Status codes tell the payer that a device is present and may affect treatment; they are always secondary. Z95 covers cardiac and vascular implants: Z95.0 pacemaker, Z95.810 implantable defibrillator, Z95.1 coronary bypass graft, Z95.5 coronary stent, Z95.2 prosthetic heart valve, Z95.3 xenograft valve, Z95.811 heart assist device, Z95.820 peripheral vascular stent, Z95.828 other vascular implants including ports. Z96 covers functional implants, most often the artificial joints Z96.6x with laterality (Z96.651 right knee, Z96.642 left hip, Z96.653 bilateral knees), plus Z96.1 intraocular lens, Z96.82 neurostimulator, and Z96.7 bone and tendon implants. Z97 covers external devices: artificial limbs Z97.1x, dental prosthesis Z97.2, spectacles Z97.3, hearing aid Z97.4, and IUD Z97.5.

Do not report a status code when a complication of the same device is being coded; the complication code already implies the device. A patient with an infected knee prosthesis is T84.53XA, not T84.53XA plus Z96.651, and a pacemaker lead fracture is T82.110A without Z95.0. Section I.C.21.c.3 gives the same instruction for transplants. The status code returns once the complication is resolved and the device is again incidental.

Routine device checks are encounter codes, with the status code second: Z45.010 for a pacemaker battery check, Z45.018 for other pacemaker management, and Z45.02 for defibrillator interrogation, paired with Z95.0 or Z95.810 and billed with 93279 to 93296. Z47.1 aftercare after joint replacement requires the Z96.6x joint code. Status codes are also what support medical necessity for services such as endocarditis prophylaxis in a valve patient or MRI screening in a pacemaker patient.

Artificial openings work the same way. Z93 is the status: Z93.0 tracheostomy, Z93.1 gastrostomy, Z93.2 ileostomy, Z93.3 colostomy, Z93.5x cystostomy, Z93.6 other urinary diversion. When the visit is for care of the opening (tube change, stoma assessment, appliance fitting), the Z43 encounter code is first-listed instead (Z43.3 attention to colostomy, Z43.0 attention to tracheostomy, Z43.1 attention to gastrostomy), and Z93 is not added, because Z43 carries an Excludes1 note for the status-only codes. A complication of the stoma such as a colostomy infection is K94.02 and again replaces both.