ICD-10-CM Code Z96.611

Presence of right artificial shoulder joint

Version 2020 Billable Code Unacceptable Principal Diagnosis

Valid for Submission

Z96.611 is a billable code used to specify a medical diagnosis of presence of right artificial shoulder joint. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z96.611 might also be used to specify conditions or terms like history of hemiarthroplasty of right shoulder or history of reverse prosthetic total arthroplasty of right shoulder or history of revision of right total shoulder arthroplasty or history of right shoulder arthroplasty or history of total arthroplasty of right shoulder joint.

The code Z96.611 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:Z96.611
Short Description:Presence of right artificial shoulder joint
Long Description:Presence of right artificial shoulder joint

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:

  • History of hemiarthroplasty of right shoulder
  • History of reverse prosthetic total arthroplasty of right shoulder
  • History of revision of right total shoulder arthroplasty
  • History of right shoulder arthroplasty
  • History of total arthroplasty of right shoulder joint

Diagnostic Related Groups

The ICD-10 code Z96.611 is grouped in the following groups for version MS-DRG V37.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC).
applicable from 10/01/2019 through 09/30/2020.

  • 564 - OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
  • 565 - OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC
  • 566 - OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Convert Z96.611 to ICD-9

  • V43.61 - Joint replaced shoulder (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 other functional implants (Z96)

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


Artificial Limbs

People can lose all or part of an arm or leg for a number of reasons. Common ones include

  • Circulation problems from atherosclerosis or diabetes. They may cause you to need an amputation.
  • Traumatic injuries, including from traffic accidents and military combat
  • Cancer
  • Birth defects

If you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which is called a prosthesis, can help you to perform daily activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as before.


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