2026 ICD-10-CM Diagnosis Code Z95.4Presence of other heart-valve replacement

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z95

ICD-10-CM Z95.4
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z95.4 is a billable ICD-10-CM diagnosis code for presence of other heart-valve replacement. 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. Coders also document this condition as history of aortic valve replacement. 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

ICD-10-CM Code
Z95.4
Billable Status
Yes — Valid for Submission
Code Describes
Presence of other heart-valve replacement
Short Description
Presence of other heart-valve replacement
Same as the full description in the CMS dataset.
Parent Code
Z95
Presence of cardiac and vascular implants and grafts

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ77-Z99Persons with potential health hazards related to family and personal history and certain conditions influencing health status
CategoryZ95Presence of cardiac and vascular implants and grafts
This CodeZ95.4Presence of other heart-valve replacement

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z95.4.

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.

Present on Admission (POA)Billing

Z95.4 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).

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • History of aortic valve replacement
  • History of artificial heart valve
  • History of bioprosthetic transcatheter mitral valve replacement
  • History of heart valve repair
  • History of pulmonary valve replacement
  • History of pulmonary valvuloplasty
  • History of tissue graft aortic valve replacement
  • History of tissue graft heart valve replacement
  • Transplanted heart valve present

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.

CCSR FAC009
Implant, device or graft related encounter
Default principal diagnosis: inpatient No · outpatient No
CCSR CIR003
Nonrheumatic and unspecified valve disorders
Default principal diagnosis: inpatient No · outpatient Yes

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 Z95.4 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V42.2 Heart valve transplant
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About Z95.4Overview

What is the ICD-10 code for presence of other heart-valve replacement?

The ICD-10-CM code for presence of other heart-valve replacement is Z95.4 (sometimes written as Z954). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is Z95.4 (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 other heart-valve replacement on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z95.4 group to?

On inpatient claims, presence of other heart-valve replacement 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 Z95.4 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because presence of other heart-valve replacement describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z95.4 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 other heart-valve replacement on inpatient claims. The code appears in the Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) range of the CMS exempt list.