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Z96.643

Z96.643Presence of artificial hip joint, bilateral

Billable / specific codeICD-10-CMbilateral

Z96.643 is a billable, specific ICD-10-CM code for presence of artificial hip joint, bilateral. It is valid for submission on a claim.

Risk adjustment

Z96.643 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

Z96.643 is named in 10 Medicare coverage policies 10 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
  • A53065Billing and Coding: Outpatient Physical Therapy
  • A56777Billing and Coding: Total Joint Arthroplasty

Related codes at this level

Codes that share Z96.64. If Z96.643 is not quite right, the correct code is usually one of these.

Questions about Z96.643

Is Z96.643 a billable ICD-10-CM code?
Yes. Z96.643 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z96.643 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).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.