Z95.812

Z95.812: Presence of fully implantable artificial heart

Billable / specific codeICD-10-CMPOA exempt

Z95.812 is a billable, specific ICD-10-CM code for presence of fully implantable artificial heart. It is valid for submission on a claim.

Check Z95.812 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above Z95.812

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 Z95.812

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

Z18Retained foreign body fragments
Z94.1Heart transplant status

Risk adjustment

Z95.812 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

Z95.812 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56625Billing and Coding: Echocardiography
A56781Billing and Coding: Transthoracic Echocardiography (TTE)
A57306Billing and Coding: Transthoracic Echocardiography (TTE)

Alphabetic index entries that lead here

Replacement by artificial or mechanical device or prosthesis of›heart
Dependence›on›artificial heart(fully implantable) (mechanical)
Presence›artificial›heart(fully implantable) (mechanical)
Presence›implanted device›heart
Status›organ replacement›by artificial or mechanical device or prosthesis of›heart

Code history

Unchanged in every release from FY2024 to FY2027.