- ICD-10-CM Index
- Chapter: Z00–Z99
- Section: Z77-Z99
- Block: Z95
- Z95.811 - Presence of heart assist device
Valid for Submission
Z95.811 is a billable diagnosis code used to specify a medical diagnosis of presence of heart assist device. The code Z95.811 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code Z95.811 might also be used to specify conditions or terms like left ventricular assist device present, patient on circulatory assist or patient on intra-aortic balloon pump assist. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code Z95.811 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.
|Short Description:||Presence of heart assist device|
|Long Description:||Presence of heart assist device|
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)
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 Z95.811 are found in the index:
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.
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Left ventricular assist device present
- Patient on circulatory assist
- Patient on intra-aortic balloon pump assist
Z95.811 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 Code||POA Reason for Code||CMS will pay the CC/MCC DRG?|
|Y||Diagnosis was present at time of inpatient admission.||YES|
|N||Diagnosis was not present at time of inpatient admission.||NO|
|U||Documentation insufficient to determine if the condition was present at the time of inpatient admission.||NO|
|W||Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.||YES|
|1||Unreported/Not used - Exempt from POA reporting. ||NO|
- V43.21 - Heart assist dev replace
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)