2027 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 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z96.1 is a billable ICD-10-CM diagnosis code for presence of intraocular lens. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) 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
  • Pupillary capture of intraocular lens
  • Tilted intraocular lens

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z96.1: its own notes plus those printed at Z96, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Presence of pseudophakia

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Z96 Presence of other functional implants applies to 40 codes
  • complications of internal prosthetic devices, implants and grafts (T82-T85)
  • fitting and adjustment of prosthetic and other devices (Z44-Z46)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status applies to 567 codes
  • any follow-up examination (Z08-Z09)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
  • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
  • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name Z96.1, its category, or a range that includes it.

Excludes1 3

These codes carry an Excludes1 note naming Z96.1: they are not reported together with it, unless the two conditions are unrelated.

  • H27 Other disorders of lens
    pseudophakia (Z96.1)
  • H59 Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
    pseudophakia (Z96.1)
  • Z18 Retained foreign body fragments
    organ or tissue replaced by means other than transplant (Z96.-, Z97.-) names Z96.-, which includes this code

Excludes2 4

These codes carry an Excludes2 note naming Z96.1: its condition is not part of those codes, and both may be reported when the patient has both.

  • Z87.7 Personal history of (corrected) congenital malformations
    presence of other functional implants (Z96.-) names Z96.-, which includes this code
  • M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
    presence of functional implants and other devices (Z96-Z97) names Z96-Z97, which includes this code
  • Z45.018 Encounter for adjustment and management of other part of cardiac pacemaker
    presence of prosthetic and other devices (Z95.1-Z95.5, Z95.811-Z97) names Z95.811-Z97, which includes this code
  • Z46 Encounter for fitting and adjustment of other devices
    presence of prosthetic and other devices (Z95-Z97) names Z95-Z97, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and Z96.1 is one of the codes named.

  • Z98.4 Cataract extraction status
    code to identify intraocular lens implant status (Z96.1)

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 Yes

Clinical InformationClinical

  • Pseudophakia

    presence of an intraocular lens after cataract extraction.

Patient EducationClinical

Cataract

A cataract is a clouding of the clear lens inside your eye. This cloudiness blocks light from reaching the back of the eye, making it harder to see clearly. A cataract can affect one or both eyes, but it doesn't spread from one eye to the other.

The full article covers:

  • What are cataracts?
  • What causes cataracts?
  • Who is more likely to develop cataracts?
  • What are the symptoms of cataracts?
  • How are cataracts diagnosed?
  • How are cataracts treated?
  • Can cataracts be prevented?

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 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About Z96.1Overview

What is the ICD-10 code for presence of intraocular lens?

The ICD-10-CM code for presence of intraocular lens is Z96.1 (sometimes written as Z961). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

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, 2026 through September 30, 2027.

What MS-DRG does Z96.1 group to?

On inpatient claims, presence of intraocular lens maps to MS-DRG 125, 124, with relative weights from 0.7699 to 1.2470 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.