Z97.12

Z97.12: Presence of artificial left arm (complete) (partial)

Billable / specific codeICD-10-CMPOA exemptleft

Z97.12 is a billable, specific ICD-10-CM code for presence of artificial left arm (complete) (partial). It is valid for submission on a claim.

Check Z97.12 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above Z97.12

A category’s note binds every code beneath it.

Written on Z97: Presence of other devices

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

Excludes2 inherited from the categories above Z97.12

Not part of this code, but both may be coded when both are present.

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 Z97.12

Their own Excludes1 notes name this code, so the conflict is not listed above.

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

Z97.12 is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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

Code history

Unchanged in every release from FY2024 to FY2027.