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ICD-10-CM Z95.811: Presence of heart assist device

Z95.811 is the billable ICD-10-CM code for presence of heart assist device, in category Z95 (Presence of cardiac and vascular implants and grafts) of the Persons with potential health hazards related to family and personal history and certain conditions influencing health status section. As a principal diagnosis it groups to MS-DRG 314 Other Circulatory System Diagnoses with MCC, MS-DRG 315 Other Circulatory System Diagnoses with CC, MS-DRG 316 Other Circulatory System Diagnoses without CC/MCC (MDC 05 MDC 05: Diseases and Disorders of the Circulatory System). It maps to HCC 223 (Heart Failure with Heart Assist Device/Artificial Heart) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 21 principal diagnoses. 6 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
Z95.811
billable FY2027 ICD-10-CM code
Category
Z95 Presence of cardiac and vascular implants and grafts
Chapter
21: Factors influencing health status and contact with health services (Z00-Z99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 223
POA reporting
Exempt

Tabular list notes for Z95.811

The tabular list has no notes on Z95.811 itself; the notes below apply from its parent headings.

Inherited from Z95 (Presence of cardiac and vascular implants and grafts)

Excludes2 (not part of this condition, may be coded together)
  • complications of cardiac and vascular devices, implants and grafts (T82.-)

MS-DRG grouping when Z95.811 is the principal diagnosis

MS-DRG v44 groups for Z95.811 as principal diagnosis
MDCMS-DRGs
05 MDC 05: Diseases and Disorders of the Circulatory System314315316

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for Z95.811 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, Z95.811 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 21 codes in its exclusion list. Check Z95.811 against a principal diagnosis.

  • Present on admission: exempt from POA indicator reporting (FY2027 exempt list).
  • Medicare Code Editor: unacceptable principal diagnosis.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, Z95.811 maps to HCC 223 (Heart Failure with Heart Assist Device/Artificial Heart). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list Z95.811

6 current Medicare billing and coding articles list Z95.811 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM Z95.811 mean?

Z95.811 means presence of heart assist device. It is one of 13 billable codes under Z95, presence of cardiac and vascular implants and grafts.

Which MS-DRG does Z95.811 group to?

As the principal diagnosis, Z95.811 groups to MS-DRG 314 Other Circulatory System Diagnoses with MCC, MS-DRG 315 Other Circulatory System Diagnoses with CC, MS-DRG 316 Other Circulatory System Diagnoses without CC/MCC (MDC 05 MDC 05: Diseases and Disorders of the Circulatory System) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does Z95.811 map to an HCC?

Yes: HCC 223, Heart Failure with Heart Assist Device/Artificial Heart, in the PY2027 CMS-HCC V28 mapping.

Is Z95.811 a CC or MCC?

Z95.811 is a CC under MS-DRG v44; 21 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.