Is Z95.0 a billable ICD-10-CM code?

Yes. Z95.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z95.0 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 Z95.0?

Z95.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

Z95.0

Z95.0 — Presence of cardiac pacemaker

Billable / specific codeICD-10-CMPOA exempt

Z95.0 is a billable, specific ICD-10-CM code for presence of cardiac pacemaker. 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.

adjustment or management of cardiac device (Z45.0-)
adjustment or management of cardiac pacemaker (Z45.0)
presence of automatic (implantable) cardiac defibrillator with synchronous cardiac pacemaker (Z95.810)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Presence of cardiac resynchronization therapy (CRT-P) pacemaker

Other codes that can never be billed with Z95.0

These codes carry an Excludes1 note pointing at Z95.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z95.0 alone.

Z45.018Encounter for adjustment and management of other part of cardiac pacemaker

Risk adjustment

Z95.0 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

Z95.0 is named in 18 Medicare coverage policies — 18 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing
A56423Billing and Coding: Cardiology Non-emergent Outpatient Stress Testing

How Z95.0 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 Z95.0.

Presence›CRT-P(cardiac resynchronization therapy pacemaker)
Cardiac›pacemaker›in situ
Presence›cardiac›pacemaker
Presence›implanted device›cardiac pacemaker
Status›pacemaker›cardiac
Presence›cardiac›resynchronization therapy›pacemaker

Related codes at this level

Codes that share Z95. If Z95.0 is not quite right, the correct code is usually one of these.

Questions about Z95.0

Is Z95.0 a billable ICD-10-CM code?: Yes. Z95.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z95.0 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 Z95.0?: Z95.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.