Z94.1 — Heart transplant status
Z94.1 is a billable, specific ICD-10-CM code for heart transplant status. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes1 inherited from the categories above Z94.1
These are not written on Z94.1, but they bind it: a note on a category applies to every code beneath it. Billing Z94.1 with anything listed here is a denial.
Written on Z94 — Transplanted organ and tissue status
- complications of transplanted organ or tissue - see Alphabetical Index
Excludes2 inherited from the categories above Z94.1
Also inherited, and the opposite of Excludes1: these conditions are not part of Z94.1, but a patient can have both, so you may code both.
Other codes that can never be billed with Z94.1
These codes carry an Excludes1 note pointing at Z94.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z94.1 alone.
- Z18Retained foreign body fragments
Risk adjustment
Z94.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 221 Heart Transplant Status/Complications1.053 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
Z94.1 is named in 74 Medicare coverage policies — 74 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52474Immunosuppressive Drugs - Policy Article
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
How Z94.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to Z94.1.
- Transplant›heart
The condition this code belongs to
Every code for the condition on one page, which one applies when, and the mistake coders make with it.
Code history
Z94.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share Z94. If Z94.1 is not quite right, the correct code is usually one of these.
- Z94.0Kidney transplant status
- Z94.2Lung transplant status
- Z94.3Heart and lungs transplant status
- Z94.4Liver transplant status
- Z94.5Skin transplant status
- Z94.6Bone transplant status
- Z94.7Corneal transplant status
- Z94.8Other transplanted organ and tissue status
- Z94.9Transplanted organ and tissue status, unspecified
Questions about Z94.1
- Is Z94.1 a billable ICD-10-CM code?
- Yes. Z94.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z94.1 sit in the tabular list?
- Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
- What cannot be coded together with Z94.1?
- Z94.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z94.1 (Z94) and apply to it just the same.