2026 ICD-10-CM Diagnosis Code Z95.2Presence of prosthetic heart valve
Z95.2 is a billable ICD-10-CM diagnosis code for presence of prosthetic heart valve. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 314 through 316. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Implant, device or graft related encounter; and Nonrheumatic and unspecified valve disorders.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z95.2.
Present on Admission (POA)Billing
Z95.2 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Closing click of prosthetic valve
- H/O: heart valve recipient
- History of aortic valve replacement
- History of artificial heart valve
- History of bioprosthetic transcatheter aortic valve implantation
- History of heart valve repair
- History of heart valve repair with prosthesis
- History of mechanical aortic valve replacement
- History of mechanical heart valve replacement
- History of mechanical prosthetic mitral valve replacement
- History of mitral valve prosthesis
- History of mitral valve replacement
- History of repair of mitral valve
- History of replacement of mitral valve with tissue graft
- History of transcatheter aortic valve implantation
- History of tricuspid valve replacement
- Mechanical cardiac valve prosthesis in situ
- Metal mitral valve prosthesis in situ
- Opening click of prosthetic valve
- Prosthetic heart valve in situ
- Prosthetic valve sound
- Prosthetic valve sound muffled
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Presence of heart valve NOS
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
- heart (fully implantable) (mechanical) - Z95.812
- valve - Z95.2
- heart valve implant (functional) - Z95.2
- prosthetic - Z95.2
- implanted device (artificial) (functional) (prosthetic) - Z96.9
- heart valve - Z95.2
- prosthetic - Z95.2
- Replacement by artificial or mechanical device or prosthesis of
- valve - Z95.2
- prosthetic - Z95.2
- Status (post) - See Also: Presence (of);
- Transplant (ed) (status) - Z94.9
- valve - Z95.2
- prosthetic - Z95.2
External Cause of Injuries IndexGuidance
References for this code in the External Cause of Injuries Index.
- Presence(of)
- artificial
- heart (fully implantable) (mechanical)
- valve
- Presence(of)
- heart valve implant (functional)
- Presence(of)
- heart valve implant (functional)
- prosthetic
- Presence(of)
- implanted device (artificial) (functional) (prosthetic)
- heart valve
- Presence(of)
- implanted device (artificial) (functional) (prosthetic)
- heart valve
- prosthetic
- Replacement by artificial or mechanical device or prosthesis of
- heart
- valve
- Replacement by artificial or mechanical device or prosthesis of
- heart
- valve
- prosthetic
- Status(post)
- organ replacement
- by artificial or mechanical device or prosthesis of
- heart
- valve
- Transplant(ed) (status)
- heart
- valve
- Transplant(ed) (status)
- heart
- valve
- prosthetic
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Heart Valve Diseases
Heart valve disease happens when one or more of your heart valves don't work well.
The full article covers:
- What are heart valve diseases?
- What are the types of heart valve diseases?
- What causes heart valve diseases?
- Who is more likely to develop heart valve diseases?
- What are the symptoms of heart valve diseases?
- What other problems can heart valve diseases cause?
- How is heart valve disease diagnosed?
- What are the treatments for heart valve diseases?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z95.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z95.2Overview
Is Z95.2 (Presence of cardiac and vascular implants and grafts) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report presence of prosthetic heart valve on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does Z95.2 group to?
On inpatient claims, presence of prosthetic heart valve maps to MS-DRG 314, 315, 316, with relative weights from 0.6821 to 2.0852 depending on complications. Higher weights mean higher Medicare reimbursement.
Can Z95.2 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because presence of prosthetic heart valve describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z95.2 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for presence of prosthetic heart valve on inpatient claims.
What is the ICD-9 equivalent of Z95.2?
Under the General Equivalence Mappings, presence of prosthetic heart valve converts to ICD-9-CM V43.3 (heart valve replac NEC). The mapping is approximate, so confirm the match fits the documentation.
