Is Z96.659 a billable ICD-10-CM code?

Yes. Z96.659 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z96.659 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).

Z96.659

Z96.659 — Presence of unspecified artificial knee joint

Billable / specific codeICD-10-CMunspecified

Z96.659 is a billable, specific ICD-10-CM code for presence of unspecified artificial knee joint. It is valid for submission on a claim.

Risk adjustment

Z96.659 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

Z96.659 is named in 3 Medicare coverage policies — 3 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
A56796Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
A57765Billing and Coding: Major Joint Replacement (Hip and Knee)

Related codes at this level

Codes that share Z96.65. If Z96.659 is not quite right, the correct code is usually one of these.

Questions about Z96.659

Is Z96.659 a billable ICD-10-CM code?: Yes. Z96.659 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z96.659 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).