ICD-10-CM Code Z96.643

Presence of artificial hip joint, bilateral

Version 2020 Billable Code Unacceptable Principal Diagnosis

Valid for Submission

Z96.643 is a billable code used to specify a medical diagnosis of presence of artificial hip joint, bilateral. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z96.643 might also be used to specify conditions or terms like history of hemiarthroplasty of bilateral hips, history of hemiarthroplasty of left hip, history of hemiarthroplasty of right hip, history of left hip replacement, history of prosthetic arthroplasty of bilateral hips, history of repair of hip joint, etc

The code Z96.643 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:Z96.643
Short Description:Presence of artificial hip joint, bilateral
Long Description:Presence of artificial hip joint, bilateral

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 bilateral hips
  • History of hemiarthroplasty of left hip
  • History of hemiarthroplasty of right hip
  • History of left hip replacement
  • History of prosthetic arthroplasty of bilateral hips
  • History of repair of hip joint
  • History of repair of hip joint
  • History of right hip replacement
  • History of total hip arthroplasty
  • History of total replacement of bilateral hip joints
  • History of total replacement of left hip joint
  • History of total replacement of right hip joint

Diagnostic Related Groups

The ICD-10 code Z96.643 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 Z96.643 to ICD-9

  • V43.64 - Joint replaced hip (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


Hip Replacement

Hip replacement is surgery for people with severe hip damage. The most common cause of damage is osteoarthritis. Osteoarthritis causes pain, swelling, and reduced motion in your joints. It can interfere with your daily activities. If other treatments such as physical therapy, pain medicines, and exercise haven't helped, hip replacement surgery might be an option for you.

During a hip replacement operation, the surgeon removes damaged cartilage and bone from your hip joint and replaces them with new, man-made parts.

A hip replacement can

  • Relieve pain
  • Help your hip joint work better
  • Improve walking and other movements

The most common problem after surgery is hip dislocation. Because a man-made hip is smaller than the original joint, the ball can come out of its socket. The surgery can also cause blood clots and infections. With a hip replacement, you might need to avoid certain activities, such as jogging and high-impact sports.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases


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