Z95.4

Z95.4: Presence of other heart-valve replacement

Billable / specific codeICD-10-CMPOA exempt

Z95.4 is a billable, specific ICD-10-CM code for presence of other heart-valve replacement. It is valid for submission on a claim.

Check Z95.4 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above Z95.4

Not part of this code, but both may be coded when both are present.

Written on Z95: Presence of cardiac and vascular implants and grafts

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

Other codes that can never be billed with Z95.4

Their own Excludes1 notes name this code, so the conflict is not listed above.

Z18Retained foreign body fragments
Z94.1Heart transplant status

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Z95.4 is named in 14 Medicare coverage policies: 14 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52850Billing and Coding: Cardiac Catheterization and Coronary Angiography
A53775Billing and Coding: Frequency and Duration for Cardiac Rehabilitation and Intensive Cardiac Rehabilitation
A56464Billing and Coding: Flow Cytometry
A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography

Alphabetic index entries that lead here

Presence›heart valve implant›specified type NEC
Presence›implanted device›heart valve›specified NEC
Replacement by artificial or mechanical device or prosthesis of›heart›valve›specified NEC
Transplant›heart›valve›specified NEC

Code history

Unchanged in every release from FY2024 to FY2027.