Is Z97.1 a billable ICD-10-CM code?

No. Z97.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does Z97.1 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).

What cannot be coded together with Z97.1?

Z97.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z97.1 (Z97) and apply to it just the same.

Z97.1

Z97.1 — Presence of artificial limb (complete) (partial)

Non-billable headerICD-10-CM

Z97.1 is a non-billable header ICD-10-CM code for presence of artificial limb (complete) (partial). It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above Z97.1

These are not written on Z97.1, but they bind it: a note on a category applies to every code beneath it. Billing Z97.1 with anything listed here is a denial.

Written on Z97 — Presence of other devices

complications of internal prosthetic devices, implants and grafts (T82-T85)

Excludes2 inherited from the categories above Z97.1

Also inherited, and the opposite of Excludes1: these conditions are not part of Z97.1, but a patient can have both, so you may code both.

Written on Z97 — Presence of other devices

fitting and adjustment of prosthetic and other devices (Z44-Z46)
presence of cerebrospinal fluid drainage device (Z98.2)

Other codes that can never be billed with Z97.1

These codes carry an Excludes1 note pointing at Z97.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z97.1 alone.

Z18Retained foreign body fragments
Z44Encounter for fitting and adjustment of external prosthetic device

Risk adjustment

Z97.1 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.

Code history

Z97.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead Z97.1

7 child codes. Green means billable.

Related codes at this level

Codes that share Z97. If Z97.1 is not quite right, the correct code is usually one of these.

Questions about Z97.1

Is Z97.1 a billable ICD-10-CM code?: No. Z97.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does Z97.1 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).
What cannot be coded together with Z97.1?: Z97.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z97.1 (Z97) and apply to it just the same.