Z45.49Encounter for adjustment and management of other implanted nervous system device

Z45.49 is the ICD-10-CM diagnosis code for encounter for adjustment and management of other implanted nervous system device. It belongs to category Z45 (encounter for adjustment and management of implanted device), block Z40-Z53 (Encounters for other specific health care) and chapter 21 (factors influencing health status and contact with health services). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within Z45.4, choose Z45.49 (other implanted nervous system device) only when documentation doesn't support a more specific option: cerebrospinal fluid drainage device (Z45.41) and neurostimulator (Z45.42).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 091 (Other Disorders of Nervous System with MCC, relative weight 1.7046), DRG 092 (Other Disorders of Nervous System with CC, relative weight 1.0239) and DRG 093 (Other Disorders of Nervous System without CC/MCC, relative weight 0.7783), in MDC 01 (Diseases and Disorders of the Nervous System), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It is exempt from present-on-admission (POA) reporting, so no POA indicator is required.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as V53.09 (fitting and adjustment of other devices related to nervous system and special senses).