2026 ICD-10-CM Diagnosis Code Z96.1Presence of intraocular lens

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z96

ICD-10-CM Z96.1
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

Z96.1 is a billable ICD-10-CM diagnosis code for presence of intraocular lens. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 124 through 125. The code is not accepted as a principal diagnosis by the Medicare Code Editor. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Implant, device or graft related encounter.

Code Identity

ICD-10-CM Code
Z96.1
Billable Status
Yes — Valid for Submission
Code Describes
Presence of intraocular lens
Short Description
Presence of intraocular lens
Same as the full description in the CMS dataset.
Parent Code
Z96
Presence of other functional implants

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
CategoryZ96Presence of other functional implants
This CodeZ96.1Presence of intraocular lens

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z96.1.

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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Anterior capsule covering intraocular lens 360 degrees
  • Anterior chamber intraocular lens present
  • Artificial lens in position
  • Artificial lens present
  • Artificial lens present in left eye
  • Artificial lens present in right eye
  • Bilateral pseudophakia
  • H/O: artificial eye lens
  • History of cataract extraction
  • History of exchange of intraocular lens
  • History of implantation of anterior chamber intraocular lens
  • History of implantation of posterior chamber intraocular lens
  • History of penetrating keratoplasty
  • History of penetrating keratoplasty with implantation of posterior chamber intraocular lens
  • History of phacoemulsification of cataract with implantation of intraocular lens
  • History of secondary lens implant
  • Lens capsule clarity in pseudophakia - finding
  • Lens capsule clear in pseudophakia
  • Lens capsule folds in pseudophakia
  • Lens capsule in pseudophakia finding
  • Lens capsule opacity in pseudophakia
  • Lens capsule open in pseudophakia
  • Phakic intraocular lens present
  • Piggyback intraocular lens
  • Position of artificial lens - finding
  • Pseudophakia
  • Pupillary capture of intraocular lens
  • Tilted intraocular lens

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Presence of pseudophakia

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Presence(of)
      • artificial
        • lens (intraocular)
    • Presence(of)
      • implanted device (artificial) (functional) (prosthetic)
        • intraocular lens
    • Presence(of)
      • intraocular lens (functional)
    • Pseudophakia
    • Replacement by artificial or mechanical device or prosthesis of
      • lens
    • Status(post)
      • organ replacement
        • by artificial or mechanical device or prosthesis of
          • lens
    • Status(post)
      • pseudophakia

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 Yes

Clinical InformationClinical

  • Pseudophakia

    presence of an intraocular lens after cataract extraction.

Patient EducationClinical

Cataract

A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z96.1 to ICD-9-CMHistory

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

ICD-9-CM
V43.1 Lens replacement NEC
Exact Match The mapping is direct, with no qualifiers.

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 Z96.1Overview

Is Z96.1 (Presence of other functional implants) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report presence of intraocular lens on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does Z96.1 group to?

On inpatient claims, presence of intraocular lens maps to MS-DRG 124, 125, with relative weights from 0.7678 to 1.3231 depending on complications. Higher weights mean higher Medicare reimbursement.

Can Z96.1 be a principal diagnosis?

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

What is the ICD-9 equivalent of Z96.1?

Under the General Equivalence Mappings, presence of intraocular lens converts to ICD-9-CM V43.1 (lens replacement NEC). The mapping is a direct match.