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.
Risk adjustment
Z97.12 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
Z97.12 is named in 5 Medicare coverage policies — 5 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 Z97.1. If Z97.12 is not quite right, the correct code is usually one of these.
- Z97.10Presence of artificial limb (complete) (partial), unspecified
- Z97.11Presence of artificial right arm (complete) (partial)
- Z97.13Presence of artificial right leg (complete) (partial)
- Z97.14Presence of artificial left leg (complete) (partial)
- Z97.15Presence of artificial arms, bilateral (complete) (partial)
- Z97.16Presence of artificial legs, bilateral (complete) (partial)
Questions about Z97.12
- Is Z97.12 a billable ICD-10-CM code?
- Yes. Z97.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does Z97.12 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).