ICDcodes.org
FY2027

Z94.1 — Heart transplant status

BillableCC

Is Z94.1 billable?

Yes — Z94.1 is billable for FY2027. Z94.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z94.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z94.1 at a glance

CodeZ94.1
DescriptionHeart transplant status
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to Z94.1?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z94.1 directly.

Cannot be a principal diagnosis — MCE edit 9

CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.

Which MS-DRGs does Z94.1 group to?

Z94.1 sits in MDC 05 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

  • 314Other Circulatory System Diagnoses with MCCmedical
  • 315Other Circulatory System Diagnoses with CCmedical
  • 316Other Circulatory System Diagnoses without CC/MCCmedical

As a secondary diagnosis, Z94.1 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is Z94.1 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z94.1. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Transplant › heart (ed) (status)

Excludes1 — never code together

The conditions below can never be reported together with Z94.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • artificial heart status (Z95.812)
  • heart-valve replacement status (Z95.2-Z95.4)

Excludes1 — never code together — inherited from Z94

The conditions below can never be reported together with Z94.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • complications of transplanted organ or tissue - see Alphabetical Index

Excludes2 — not included here — inherited from Z94

The conditions below are not part of Z94.1, but a patient may have both at the same time. When documentation supports it, Z94.1 and the excluded code may both be reported.

  • presence of vascular grafts (Z95.-)

Code also — inherited from Z77-Z99

Two codes may be needed to describe the condition fully. Whether Z94.1 is sequenced first depends on the reason for the encounter.

  • any follow-up examination (Z08-Z09)

How long has Z94.1 existed?

Z94.1 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which codes are confused with Z94.1?

ICD-10-CM declares these codes mutually exclusive with Z94.1 — exactly one of each pair can be correct for a given encounter.

Which conditions are coded to Z94.1?

What other codes are in the Z94 family? (9)