Is Z96.619 a billable ICD-10-CM code?

Yes. Z96.619 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z96.619 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).

Z96.619

Z96.619 — Presence of unspecified artificial shoulder joint

Billable / specific codeICD-10-CMunspecified

Z96.619 is a billable, specific ICD-10-CM code for presence of unspecified artificial shoulder joint. It is valid for submission on a claim.

Excludes2 inherited from the categories above Z96.619

Also inherited, and the opposite of Excludes1: these conditions are not part of Z96.619, but a patient can have both, so you may code both.

Written on Z96 — Presence of other functional implants

complications of internal prosthetic devices, implants and grafts (T82-T85)
fitting and adjustment of prosthetic and other devices (Z44-Z46)

Other codes that can never be billed with Z96.619

These codes carry an Excludes1 note pointing at Z96.619. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z96.619 alone.

Z18Retained foreign body fragments

Risk adjustment

Z96.619 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

Z96.619 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53064Billing and Coding: Outpatient Occupational Therapy

Code history

Z96.619 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 Z96.619 is not quite right, the correct code is usually one of these.

Questions about Z96.619

Is Z96.619 a billable ICD-10-CM code?: Yes. Z96.619 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z96.619 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).