Z95.2 — Presence of prosthetic heart valve

Billable

Is Z95.2 billable?

Yes — Z95.2 is billable for FY2027. Z95.2 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z95.2 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z95.2 at a glance

Code	Z95.2
Description	Presence of prosthetic heart valve
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to Z95.2?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z95.2 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 Z95.2 group to?

Z95.2 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

How is Z95.2 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to Z95.2. They show the wording a clinician may have documented, which often differs from the Tabular description.

Presence › heart valve implant (of)
Presence › heart valve implant › prosthetic (of)
Presence › implanted device › heart valve (of)
Replacement by artificial or mechanical device or prosthesis of › heart › valve
Transplant › heart › valve (ed) (status)
Presence › artificial › heart › valve (of)
Presence › implanted device › heart valve › prosthetic (of)
Replacement by artificial or mechanical device or prosthesis of › heart › valve › prosthetic
Transplant › heart › valve › prosthetic (ed) (status)
Status › organ replacement › by artificial or mechanical device or prosthesis of › heart › valve (post)

Inclusion terms

Alternative wording in documentation that is classified to Z95.2.

Presence of heart valve NOS

Excludes2 — not included here — inherited from Z95

The conditions below are not part of Z95.2, but a patient may have both at the same time. When documentation supports it, Z95.2 and the excluded code may both be reported.

complications of cardiac and vascular devices, implants and grafts (T82.-)

Code also — inherited from Z77-Z99

Two codes may be needed to describe the condition fully. Whether Z95.2 is sequenced first depends on the reason for the encounter.

any follow-up examination (Z08-Z09)

How long has Z95.2 existed?

Z95.2 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 conditions are coded to Z95.2?

ICD-10 code for Transplant