FY2027
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Excludes1 pair

Z45.0- vs Z95.0

Z45.0 and Z95.0 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on Z95.0
adjustment or management of cardiac pacemaker (Z45.0)
Z45.0

Encounter for adjustment and management of cardiac device

Not billable
Chapter 21
Factors influencing health status and contact with health services
Section
Z40-Z53
Z95.0

Presence of cardiac pacemaker

Billable
Chapter 21
Factors influencing health status and contact with health services
Section
Z77-Z99
Use when the record says
  • Presence of cardiac resynchronization therapy (CRT-P) pacemaker
Indexed under
  • Presence › CRT-P (cardiac resynchronization therapy pacemaker)
  • Cardiac › pacemaker › in situ
  • Presence › cardiac › pacemaker
  • Presence › implanted device › cardiac pacemaker
  • Status › pacemaker › cardiac

Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027