ICD-10-CM Code Z95.5

Presence of coronary angioplasty implant and graft

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z95.5 is a billable code used to specify a medical diagnosis of presence of coronary angioplasty implant and graft. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z95.5 might also be used to specify conditions or terms like bare metal stent in anterior descending branch of left coronary artery, bare metal stent in branch of right coronary artery, bare metal stent in circumflex branch of left coronary artery, bare metal stent in posterior descending branch of right coronary artery, drug coated stent in anterior descending branch of left coronary artery, drug coated stent in branch of right coronary artery, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z95.5 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

ICD-10:Z95.5
Short Description:Presence of coronary angioplasty implant and graft
Long Description:Presence of coronary angioplasty implant and graft

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z95.5:

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • coronary angioplasty status without implant and graft Z98.61

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z95.5 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Bare metal stent in anterior descending branch of left coronary artery
  • Bare metal stent in branch of right coronary artery
  • Bare metal stent in circumflex branch of left coronary artery
  • Bare metal stent in posterior descending branch of right coronary artery
  • Drug coated stent in anterior descending branch of left coronary artery
  • Drug coated stent in branch of right coronary artery
  • Drug coated stent in circumflex branch of left coronary artery
  • Drug coated stent in posterior descending branch of right coronary artery
  • History of placement of stent for coronary artery disease
  • History of placement of stent in anterior descending branch of left coronary artery
  • History of placement of stent in circumflex branch of left coronary artery
  • Stent in anterior descending branch of left coronary artery
  • Stent in branch of right coronary artery
  • Stent in circumflex branch of left coronary artery
  • Stent in posterior descending branch of right coronary artery
  • Stented coronary artery

Present on Admission (POA)

Z95.5 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z95.5 to ICD-9

  • V45.82 - Status-post ptca (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
      • Presence of cardiac and vascular implants and grafts (Z95)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Angioplasty

If you have coronary artery disease, the arteries in your heart are narrowed or blocked by a sticky material called plaque. Angioplasty is a procedure to restore blood flow through the artery.

You have angioplasty in a hospital. The doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end. When the tube is in place, the doctor inflates the balloon to push the plaque outward against the wall of the artery. This widens the artery and restores blood flow.

Doctors may use angioplasty to

  • Reduce chest pain caused by reduced blood flow to the heart
  • Minimize damage to heart muscle from a heart attack

Many people go home the day after angioplasty, and are able to return to work within a week of coming home.

NIH: National Heart, Lung, and Blood Institute


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