Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives: 3 inclusion terms · 8 Excludes1

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

MS-DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z18.32 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on Z18.32 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

embedded fragment (status)
embedded splinter (status)
retained foreign body status

Source: inherited from Z18

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

artificial joint prosthesis status (Z96.6-) Compare Z18.32 vs Z96.6 →
foreign body accidentally left during a procedure (T81.5-) Compare Z18.32 vs T81.5 →
foreign body entering through orifice (T15-T19) Compare Z18.32 vs T15 →
in situ cardiac device (Z95.-) Compare Z18.32 vs Z95 →
organ or tissue replaced by means other than transplant (Z96.-, Z97.-) Compare Z18.32 vs Z96 →
organ or tissue replaced by transplant (Z94.-) Compare Z18.32 vs Z94 →
personal history of retained foreign body fully removed Z87.821
superficial foreign body (non-embedded splinter) - code to superficial foreign body, by site

Source: inherited from Z18

Coder workflow for Z18.32

MedCoder structured workflow — derived from this code’s own official record

Before you code Z18.32

Confirm the reason for the encounter this Z code records: the circumstance it records. Check whether the code may be reported as first-listed or principal — some Z codes are limited to one position — and do not report a history or status code for a condition documented as current. Z code categories and their reporting positions (Guidelines I.C.21.c, I.C.21.c.15).
Guide: Z codes as principal or first-listed diagnosis →
Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z18.32. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
See the official tabular notes

Choose the right path

Does the documentation support a condition named in Z18.32’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
ReviewZ96.6, T81.5, Z95, Z96, Z97, Z94

Consider Z18.32. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement: Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The reason for the encounter: Whether the code records the encounter’s purpose, a status, or a history — and whether it may be first-listed (Guidelines I.C.21.c).

Official instructions as workflow

Excludes1 — check before selecting Z18.32(8 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z18.32: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
CompareZ96.6, T81.5, Z95, Z96, Z97, Z94
See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition Z18.32 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewZ96.6, T81.5, Z95, Z96, Z97, Z94

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Retained tooth is a billable ICD-10-CM diagnosis code (Z18.32).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)

Codes from category Z15 should generally not be used as principal or first-listed codes. If the patient has the condition to which he/she is susceptible, and that condition is the reason for the encounter, the code for the current condition should be sequenced first. If the patient is being seen for follow-up after completed treatment for this condition, and the condition no longer exists, a follow-up code should be sequenced first, followed by the appropriate personal history and genetic susceptibility codes. If the purpose of the encounter is genetic counseling associated with procreative management, code Z31.5, Encounter for genetic counseling, should be assigned as the first-listed code, followed by a code from category Z15. Additional codes should be assigned for any applicable family or personal history. Z16 Resistance to antimicrobial drugs This category indicates that a patient has a condition that is resistant to antimicrobial drug treatment. Sequence the infection code first. Z17 Estrogen, and other hormones and factors receptor status Z18 Retained foreign body fragments Z19 Hormone sensitivity malignancy status Z21 Asymptomatic HIV infection status This code indicates that a patient has tested positive for HIV but has manifested no signs or symptoms of the disease. Z22 Carrier of infectious disease Carrier status indicates that a person harbors the specific organisms of a disease without manifest symptoms and is capable of transmitting the infection. Z28.3 Underimmunization status

Don’t confuse Z18.32 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of Z18.32 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

Z96.6— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of artificial joint prosthesis status moves the case to Z96.6; the two are not reported together unless documented as unrelated.
Full comparison: Z18.32 vs Z96.6 →
T81.5— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of foreign body accidentally left during a procedure moves the case to T81.5; the two are not reported together unless documented as unrelated.
Full comparison: Z18.32 vs T81.5 →
T15— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of foreign body entering through orifice moves the case to T15; the two are not reported together unless documented as unrelated.
Full comparison: Z18.32 vs T15 →
T19— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of foreign body entering through orifice moves the case to T19; the two are not reported together unless documented as unrelated.
Full comparison: Z18.32 vs T19 →
Z95— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of in situ cardiac device moves the case to Z95; the two are not reported together unless documented as unrelated.
Full comparison: Z18.32 vs Z95 →
Z96— Excludes1 conflict (Excludes1 — generally not reported together)
Not coded here — the tabular list excludes this pair for the same encounter.
Not reported together with this code, except where the two conditions are documented as unrelated.
What moves you there: Documentation of artificial joint prosthesis status moves the case to Z96; the two are not reported together unless documented as unrelated.
Full comparison: Z18.32 vs Z96 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name Z18.32 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: Z03.82 — Encounter for observation for suspected foreign body ruled out (via Z18.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Excludes2 note: Z77 — Other contact with and (suspected) exposures hazardous to health (via Z18.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

These codes instruct coders to additionally report this code when it applies.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 1 MS-DRG: DRG 951 (MDC 23).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):FAC025 — Other specified status (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified status).

Z14.02 — Symptomatic hemophilia A carrier, Z14.1 — Cystic fibrosis carrier, Z14.8 — Genetic carrier of other disease, Z18.01 — Retained depleted uranium fragments, Z18.09 — Other retained radioactive fragments, Z18.10 — Retained metal fragments, unspecified, Z18.11 — Retained magnetic metal fragments, Z18.12 — Retained nonmagnetic metal fragments, Z18.2 — Retained plastic fragments, Z18.31 — Retained animal quills or spines, Z18.33 — Retained wood fragments, Z18.39 — Other retained organic fragments, Z18.81 — Retained glass fragments, Z18.83 — Retained stone or crystalline fragments, Z18.89 — Other specified retained foreign body fragments, Z18.9 — Retained foreign body fragments, unspecified material, Z52.000 — Unspecified donor, whole blood, Z52.001 — Unspecified donor, stem cells, Z52.008 — Unspecified donor, other blood, Z52.010 — Autologous donor, whole blood, +232 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Retained”; these codes share that main term but sit in a different category of the Tabular List.

K91.86 — Retained cholelithiasis following cholecystectomy

Contextual Map

Every relationship of Z18.32 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run Z18.32 with these 10 related codes in Claim Check

Hierarchy

Z00-Z99 — Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99) (Z00-Z99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18-Z18 — Retained foreign body fragments[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

Z03.82 — Encounter for observation for suspected foreign body ruled out[Excludes1](via Z18.-): “retained foreign body (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

Z77 — Other contact with and (suspected) exposures hazardous to health[Excludes2](via Z18.-): “retained foreign body (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Use Additional Code instructions (24)

H02.81 — Retained foreign body in eyelid[Use Additional Code](via Z18.-): “code to identify the type of retained foreign body (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
H05.5 — Retained (old) foreign body following penetrating wound of orbit[Use Additional Code](via Z18.-): “code to identify the type of retained foreign body (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
H44.7 — Retained (old) intraocular foreign body, nonmagnetic[Use Additional Code]: “code to identify nonmagnetic foreign body (Z18.01-Z18.10, Z18.12, Z18.2-Z18.9)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
L92.3 — Foreign body granuloma of the skin and subcutaneous tissue[Use Additional Code](via Z18.-): “code to identify the type of retained foreign body (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
M60.2 — Foreign body granuloma of soft tissue, not elsewhere classified[Use Additional Code](via Z18.-): “code to identify the type of retained foreign body (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R78 — Findings of drugs and other substances, not normally found in blood[Use Additional Code](via Z18.-): “code to identify any retained foreign body, if applicable (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R79 — Other abnormal findings of blood chemistry[Use Additional Code](via Z18.-): “code to identify any retained foreign body, if applicable (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R82 — Other and unspecified abnormal findings in urine[Use Additional Code](via Z18.-): “code to identify any retained foreign body, if applicable (Z18.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
and 16 more

Clinical classification (CCSR)

FAC025 — Other specified status[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

DRG 951 — OTHER FACTORS INFLUENCING HEALTH STATUS[MS-DRG]: “OTHER FACTORS INFLUENCING HEALTH STATUS (MDC 23)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

MDC 23 — Factors Influencing Health Status and Other Contacts with Health Services[MDC crossing]: “Factors Influencing Health Status and Other Contacts with Health Services — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,235 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

Retained, foreign body fragments (type of), tooth (teeth)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Retained, fragments (type of ), tooth (teeth)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (18)

Z18 — Retained foreign body fragments[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18.0 — Retained radioactive fragments[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18.01 — Retained depleted uranium fragments[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18.09 — Other retained radioactive fragments[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18.1 — Retained metal fragments[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18.10 — Retained metal fragments, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18.11 — Retained magnetic metal fragments[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Z18.12 — Retained nonmagnetic metal fragments[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
and 10 more

Change history

FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data: CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data: ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data: CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data: CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data: CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship: Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation: Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

FY2016 — October 1, 2015
In the code set at ICD-10-CM adoption
Retained tooth

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to Z18.32 in its code family, with their registry titles.

View all codes in the Z18 family

Z18.32 ICD-10-CM Code: Retained tooth

Coding at a Glance

Inpatient Payment Groups (MS-DRG)

Coding instructions

Includes

Excludes1 — Not Coded Here

Coder workflow for Z18.32

Before you code Z18.32

Choose the right path

Documentation check

Official instructions as workflow

Coding decision scenarios

Code Overview

Indexed Clinical Terms (2)

Official Coding Guidelines

Don’t confuse Z18.32 with…

Verify Before Coding

Relationships & Classification

MS-DRG Grouper Relationships (FY2026)

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Same clinical category (CCSR)

Same Index main term, other category

Contextual Map

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Use Additional Code instructions (24)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

Index entries

Nearest codes (18)

Change history

Relevant guides

Sources for this page

Change history

Nearest Codes in This Family