FY2027
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Excludes1 pair

Z45- vs Z95.0

Z45 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 device (Z45.0-)
Z45

Encounter for adjustment and management of implanted device

Not billable
Chapter 21
Factors influencing health status and contact with health services
Section
Z40-Z53
Use when the record says
  • removal or replacement of implanted device
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