2027 ICD-10-CM Diagnosis Code Z94.2Lung transplant status
ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z94
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 276
- POA Exempt
- Not a Principal Diagnosis
Z94.2 is a billable ICD-10-CM diagnosis code for lung transplant status. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 205 through 206. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 15 closely related codes. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as H/O: lung recipient. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Organ transplant status.
For Medicare Advantage risk adjustment, Z94.2 maps to CMS-HCC Category 276 (Lung Transplant Status/Complications) under the V28 model, adding a risk factor of about 2.531 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z94.2.
Present on Admission (POA)Billing
Z94.2 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
Medicare Risk Adjustment (HCC)Billing
Z94.2 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- H/O: lung recipient
- Transplanted lung present
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z94.2: its own notes plus those printed at Z94, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- organ or tissue replaced by heterogenous or homogenous transplant
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- complications of transplanted organ or tissue - see Alphabetical Index
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z94.2, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming Z94.2: they are not reported together with it, unless the two conditions are unrelated.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Lung Transplantation
A lung transplant removes a person's diseased lung and replaces it with a healthy one. The healthy lung comes from a donor who has died. Some people get one lung during a transplant. Other people get two.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z94.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z94.2Overview
What is the ICD-10 code for lung transplant status?
The ICD-10-CM code for lung transplant status is Z94.2 (sometimes written as Z942). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z94.2 (Transplanted organ and tissue status) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report lung transplant status on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z94.2 group to?
On inpatient claims, lung transplant status maps to MS-DRG 206, 205, with relative weights from 0.9255 to 1.8244 depending on complications. Higher weights mean higher Medicare reimbursement.
Is Z94.2 a CC or MCC?
CMS lists Z94.2 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 15 closely related codes in its exclusion list.
Can Z94.2 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because lung transplant status describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
What HCC is Z94.2?
Z94.2 (lung transplant status) maps to CMS-HCC Category 276 (Lung Transplant Status/Complications), commonly written as HCC 276, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 186 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 396.
Does Z94.2 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, Z94.2 adds a risk adjustment factor of about 2.531 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 1.277 to 3.085 depending on the payment segment). HCC 276 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 276 category page.
