Z95.811 — Presence of heart assist device
Is Z95.811 billable?
Yes — Z95.811 is billable for FY2027. Z95.811 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z95.811 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z95.811 at a glance
| Code | Z95.811 |
|---|---|
| Description | Presence of heart assist device |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z95.811?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z95.811 directly.
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 Z95.811 group to?
Z95.811 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, Z95.811 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is Z95.811 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to Z95.811. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Presence › heart assist device (of)
- Presence › deviceNEC › heart assist (of)
Excludes2 — not included here — inherited from Z95
The conditions below are not part of Z95.811, but a patient may have both at the same time. When documentation supports it, Z95.811 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 Z95.811 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z95.811 existed?
Z95.811 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.