2027 ICD-10-CM Diagnosis Code Z96.642Presence of left artificial hip joint
Z96.642 is a billable ICD-10-CM diagnosis code for presence of left artificial hip joint. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 564 through 566. 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
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z96.642.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- History of left hip bipolar hemiarthroplasty
- History of left hip replacement
- History of partial replacement of joint of left hip
- History of revision of left total hip arthroplasty
- History of total hip arthroplasty
- History of total replacement of left hip joint
- Pain due to and following arthroplasty of hip
- Pain due to and following arthroplasty of left hip
- Pain of left hip joint
- Wear of articular bearing surface of joint prosthesis of hip
- Wear of articular bearing surface of joint prosthesis of left hip
- Wear of articular bearing surface of prosthetic joint
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z96.642: 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.
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.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- 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 Z96.642, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming Z96.642: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 4
These codes carry an Excludes2 note naming Z96.642: 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 malformationspresence of other functional implants (Z96.-) names Z96.-, which includes this code
- M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
- Z45.018 Encounter for adjustment and management of other part of cardiac pacemaker
- Z46 Encounter for fitting and adjustment of other devices
Use Additional Code 8
These codes say to use an additional code from the note, and Z96.642 is one of the codes named.
- M97.8 Periprosthetic fracture around other internal prosthetic jointcode to identify the joint (Z96.6-) names Z96.6-, which includes this code
- T84.018 Broken internal joint prosthesis, other sitecode to identify the joint (Z96.6-) names Z96.6-, which includes this code
- T84.028 Dislocation of other internal joint prosthesiscode to identify the joint (Z96.6-) names Z96.6-, which includes this code
- T84.038 Mechanical loosening of other internal prosthetic jointcode to identify the joint (Z96.6-) names Z96.6-, which includes this code
- T84.058 Periprosthetic osteolysis of other internal prosthetic jointcode to identify the joint (Z96.6-) names Z96.6-, which includes this code
- T84.068 Wear of articular bearing surface of other internal prosthetic jointcode to identify the joint (Z96.6-) names Z96.6-, which includes this code
- T84.098 Other mechanical complication of other internal joint prosthesiscode to identify the joint (Z96.6-) names Z96.6-, which includes this code
- Z47.1 Aftercare following joint replacement surgerycode to identify the joint (Z96.6-) names Z96.6-, which includes this code
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z96.642 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z96.642Overview
What is the ICD-10 code for presence of left artificial hip joint?
The ICD-10-CM code for presence of left artificial hip joint is Z96.642 (sometimes written as Z96642). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z96.642 (Presence of artificial hip joint) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report presence of left artificial hip joint on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z96.642 group to?
On inpatient claims, presence of left artificial hip joint maps to MS-DRG 564, 566, 565, with relative weights from 0.7374 to 1.4909 depending on complications. Higher weights mean higher Medicare reimbursement.
Can Z96.642 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because presence of left artificial hip joint 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 Z96.642?
Under the General Equivalence Mappings, presence of left artificial hip joint converts to ICD-9-CM V43.64 (joint replaced hip). The mapping is approximate, so confirm the match fits the documentation.
