Z96.611 — Presence of right artificial shoulder joint
Is Z96.611 billable?
Yes — Z96.611 is billable for FY2027. Z96.611 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z96.611 may be submitted for encounters from October 1, 2026 through September 30, 2027.
Z96.611 at a glance
| Code | Z96.611 |
|---|---|
| Description | Presence of right artificial shoulder joint |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to Z96.611?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z96.611 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 Z96.611 group to?
Z96.611 sits in MDC 08 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.
- 564Other Musculoskeletal System and Connective Tissue Diagnoses with MCCmedical
- 565Other Musculoskeletal System and Connective Tissue Diagnoses with CCmedical
- 566Other Musculoskeletal System and Connective Tissue Diagnoses without CC/MCCmedical
How is Z96.611 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under Z96.61, the nearest indexed parent of Z96.611. Use them to find the family, then select the specific code.
- Presence › shoulder-joint implant (of)
- Presence › implanted device › joint › shoulder (of)
Excludes2 — not included here — inherited from Z96
The conditions below are not part of Z96.611, but a patient may have both at the same time. When documentation supports it, Z96.611 and the excluded code may both be reported.
Code also — inherited from Z77-Z99
Two codes may be needed to describe the condition fully. Whether Z96.611 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z96.611 existed?
Z96.611 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.