Valid for Submission
Z96.612 is a billable code used to specify a medical diagnosis of presence of left artificial shoulder joint. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z96.612 might also be used to specify conditions or terms like history of left shoulder arthroplasty or history of left shoulder hemiarthroplasty or history of reverse prosthetic total arthroplasty of left shoulder or history of total arthroplasty of left shoulder.
The code Z96.612 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 left artificial shoulder joint|
|Long Description:||Presence of left artificial shoulder joint|
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:
- History of left shoulder arthroplasty
- History of left shoulder hemiarthroplasty
- History of reverse prosthetic total arthroplasty of left shoulder
- History of total arthroplasty of left shoulder
Diagnostic Related Groups
The ICD-10 code Z96.612 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 Z96.612 to ICD-9
- V43.61 - Joint replaced shoulder (Approximate Flag)
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)
- 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