ICDcodes.org
FY2027

Z96.642Presence of left artificial hip joint

Billable

Is Z96.642 billable?

Yes — Z96.642 is billable for FY2027. Z96.642 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. Z96.642 may be submitted for encounters from October 1, 2026 through September 30, 2027.

Z96.642 at a glance

CodeZ96.642
DescriptionPresence of left artificial hip joint
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to Z96.642?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name Z96.642 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 Z96.642 group to?

Z96.642 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 Z96.642 listed in the Alphabetic Index?

The Alphabetic Index lists these routes under Z96.64, the nearest indexed parent of Z96.642. Use them to find the family, then select the specific code.

  • Presencehip-joint implant (of)
  • Presenceimplanted devicejointhip (of)

Excludes2 — not included here — inherited from Z96

The conditions below are not part of Z96.642, but a patient may have both at the same time. When documentation supports it, Z96.642 and the excluded code may both be reported.

  • complications of internal prosthetic devices, implants and grafts (T82-T85)
  • fitting and adjustment of prosthetic and other devices (Z44-Z46)

Code also — inherited from Z77-Z99

Two codes may be needed to describe the condition fully. Whether Z96.642 is sequenced first depends on the reason for the encounter.

  • any follow-up examination (Z08-Z09)

How long has Z96.642 existed?

Z96.642 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.

What other codes are in the Z96.64 family? (3)