Is Z95.811 a billable ICD-10-CM code?

Yes. Z95.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z95.811 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).

Z95.811

Z95.811 — Presence of heart assist device

Billable / specific codeICD-10-CMPOA exempt

Z95.811 is a billable, specific ICD-10-CM code for presence of heart assist device. It is valid for submission on a claim.

Excludes2 inherited from the categories above Z95.811

Also inherited, and the opposite of Excludes1: these conditions are not part of Z95.811, but a patient can have both, so you may code both.

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 Z95.811

These codes carry an Excludes1 note pointing at Z95.811. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z95.811 alone.

Z18Retained foreign body fragments

Risk adjustment

Z95.811 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 223 Heart Assist Device/Artificial Heart2.505 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

Z95.811 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56505Billing and Coding: Transesophageal Echocardiography (TEE)
A56625Billing and Coding: Echocardiography
A56781Billing and Coding: Transthoracic Echocardiography (TTE)
A57306Billing and Coding: Transthoracic Echocardiography (TTE)

How Z95.811 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 Z95.811.

Presence›heart assist device
Presence›device NEC›heart assist

Code history

Z95.811 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 Z95.81. If Z95.811 is not quite right, the correct code is usually one of these.

Questions about Z95.811

Is Z95.811 a billable ICD-10-CM code?: Yes. Z95.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z95.811 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).