Is Z96.642 a billable ICD-10-CM code?

Yes. Z96.642 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z96.642 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).

Z96.642

Z96.642 — Presence of left artificial hip joint

Billable / specific codeICD-10-CMleft

Z96.642 is a billable, specific ICD-10-CM code for presence of left artificial hip joint. It is valid for submission on a claim.

Risk adjustment

Z96.642 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

Z96.642 is named in 11 Medicare coverage policies — 11 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

Related codes at this level

Codes that share Z96.64. If Z96.642 is not quite right, the correct code is usually one of these.

Questions about Z96.642

Is Z96.642 a billable ICD-10-CM code?: Yes. Z96.642 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z96.642 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).