Z96.612 — Presence of left artificial shoulder joint
Z96.612 is a billable, specific ICD-10-CM code for presence of left artificial shoulder joint. It is valid for submission on a claim.
Excludes2 inherited from the categories above Z96.612
Also inherited, and the opposite of Excludes1: these conditions are not part of Z96.612, but a patient can have both, so you may code both.
Other codes that can never be billed with Z96.612
These codes carry an Excludes1 note pointing at Z96.612. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z96.612 alone.
- Z18Retained foreign body fragments
Risk adjustment
Z96.612 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
Z96.612 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.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Code history
Z96.612 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 Z96.61. If Z96.612 is not quite right, the correct code is usually one of these.
Questions about Z96.612
- Is Z96.612 a billable ICD-10-CM code?
- Yes. Z96.612 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z96.612 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).