Z96.619 — Presence of unspecified artificial shoulder joint
Is Z96.619 billable?
Yes, but Z96.619 is an unspecified code. Z96.619 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, Z96.619 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting Z96.619 — the more specific alternatives are listed below.
More specific alternatives
Z96.619 at a glance
| Code | Z96.619 |
|---|---|
| Description | Presence of unspecified 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 Z96.619?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z96.619 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 Z96.619 group to?
Z96.619 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 Z96.619 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under Z96.61, the nearest indexed parent of Z96.619. 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 Z96.619, but a patient may have both at the same time. When documentation supports it, Z96.619 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 Z96.619 is sequenced first depends on the reason for the encounter.
- any follow-up examination (Z08-Z09)
How long has Z96.619 existed?
Z96.619 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.