Z95.4Presence of other heart-valve replacement

Z95.4 is the ICD-10-CM diagnosis code for presence of other heart-valve replacement. It belongs to category Z95 (presence of cardiac and vascular implants and grafts), block Z77-Z99 (persons with potential health hazards related to family and personal history and certain conditions influencing health status) 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 Z95, choose Z95.4 (other heart-valve replacement) only when documentation doesn't support a more specific option: cardiac pacemaker (Z95.0), aortocoronary bypass graft (Z95.1), prosthetic heart valve (Z95.2), xenogenic heart valve (Z95.3), coronary angioplasty implant and graft (Z95.5), other cardiac and vascular implants and grafts (Z95.8) and cardiac and vascular implant and graft, unspecified (Z95.9).

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 314 (Other Circulatory System Diagnoses with MCC, relative weight 2.0873), DRG 315 (Other Circulatory System Diagnoses with CC, relative weight 0.9508) and DRG 316 (Other Circulatory System Diagnoses without CC/MCC, relative weight 0.6677), in MDC 05 (Diseases and Disorders of the Circulatory 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 not acceptable as the principal diagnosis for an inpatient stay; it may be reported as a secondary diagnosis.

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 V42.2 (heart valve replaced by transplant).