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Z93.0 ICD-10-CM Code: Tracheostomy status

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

Coding at a Glance

Tabular directives
2 Excludes1 · 1 code-also instruction
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 82

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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 211 — Respirator Dependence/Tracheostomy Status/Complications (supersedes HCC 212, HCC 213)

Other models: CMS-HCC V22 HCC 82

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z93.0 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 Z93.0 itself; “inherited from” names the category or block whose note applies here.

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).

Source: inherited from Z93

Code Also

Additional codes that may be required to fully describe the encounter.

  • any follow-up examination (Z08-Z09)

Source: inherited from Z77-Z99

Coder workflow for Z93.0

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

Before you code Z93.0

  1. Confirm the reason for the encounter this Z code records: a status — a condition, carrier state or sequela that may affect care, distinct from a current complication of it. 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.3, I.C.21.c.15).

    Guide: Status codes (Z codes) →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z93.0. 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

  1. Does the documentation support a condition named in Z93.0’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.

    ReviewZ43, J95.0, K94, N99.5

Consider Z93.0. Then review the Code Also note, and 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 Z93.0(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z93.0: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareZ43, J95.0, K94, N99.5

    See the official tabular notes · Guidelines I.A.12.a

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

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

Documentation: Both the condition Z93.0 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).

ReviewZ43, J95.0, K94, N99.5

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

Tracheostomy status is a billable ICD-10-CM diagnosis code (Z93.0).

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 (3)

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

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)

Status Z codes may be used with aftercare Z codes to indicate the nature of the aftercare. For example, code Z95.1, Presence of aortocoronary bypass graft, may be used with code Z48.812, Encounter for surgical aftercare following surgery on the circulatory system, to indicate the surgery for which the aftercare is being performed. A status code should not be used when the aftercare code indicates the type of status, such as using Z43.0, Encounter for attention to tracheostomy, with Z93.0, Tracheostomy status.

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

Code Z92.82 is only applicable to the receiving facility record and not to the transferring facility record. Z93 Artificial opening status Z94 Transplanted organ and tissue status Z95 Presence of cardiac and vascular implants and grafts Z96 Presence of other functional implants Z97 Presence of other devices Z98 Other postprocedural states Assign code Z98.85, Transplanted organ removal status, to indicate that a transplanted organ has been previously removed. This code should not be assigned for the encounter in which the transplanted organ is removed. The complication necessitating removal of the transplant organ should be assigned for that encounter.

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

Z99 Dependence on enabling machines and devices, not elsewhere classified Note: Categories Z89-Z90 and Z93-Z99 are for use only if there are no complications or malfunctions of the organ or tissue replaced, the amputation site or the equipment on which the patient is dependent.

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 Z93.0 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 12 Excludes2 notes across 2 chapters: T80 — Complications following infusion, transfusion and therapeutic injection (via Z93.-), T80-T88 — Complications of surgical and medical care, not elsewhere classified (T80-T88) (via Z93.-), T81 — Complications of procedures, not elsewhere classified (via Z93.-), T82 — Complications of cardiac and vascular prosthetic devices, implants and grafts (via Z93.-), T83 — Complications of genitourinary prosthetic devices, implants and grafts (via Z93.-), T84 — Complications of internal orthopedic prosthetic devices, implants and grafts (via Z93.-), T85 — Complications of other internal prosthetic devices, implants and grafts (via Z93.-), T86 — Complications of transplanted organs and tissue (via Z93.-), T87 — Complications peculiar to reattachment and amputation (via Z93.-), T88 — Other complications of surgical and medical care, not elsewhere classified (via Z93.-), Z43.1 — Encounter for attention to gastrostomy (via Z93.-), Z78 — Other specified health status (via Z93.-).

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

Referenced by 1 Use Additional Code instruction: L24.B — Irritant contact dermatitis related to stoma or fistula (via Z93.-).

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 CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Respirator Dependence/Tracheostomy Status/Complications) for risk-adjusted payment.

J95.00 — Unspecified tracheostomy complication, J95.01 — Hemorrhage from tracheostomy stoma, J95.02 — Infection of tracheostomy stoma, J95.03 — Malfunction of tracheostomy stoma, J95.04 — Tracheo-esophageal fistula following tracheostomy, J95.09 — Other tracheostomy complication, J95.850 — Mechanical complication of respirator, J95.851 — Ventilator associated pneumonia, J95.859 — Other complication of respirator [ventilator], Z43.0 — Encounter for attention to tracheostomy, Z99.11 — Dependence on respirator [ventilator] status, Z99.12 — Encounter for respirator [ventilator] dependence during power failure

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Respiratory Arrest, Cardio-Respiratory Failure and Shock

Same clinical category (CCSR)

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

Z91.A4 — Caregiver's other noncompliance with patient's medication regimen, Z91.A41 — Caregiver's other noncompliance with patient's medication regimen due to financial hardship, Z91.A48 — Caregiver's other noncompliance with patient's medication regimen for other reason, Z91.A5 — Caregiver's noncompliance with patient's renal dialysis, Z91.A51 — Caregiver's noncompliance with patient's renal dialysis due to financial hardship, Z91.A58 — Caregiver's noncompliance with patient's renal dialysis for other reason, Z91.A9 — Caregiver's noncompliance with patient's other medical treatment and regimen, Z91.A91 — Caregiver's noncompliance with patient's other medical treatment and regimen due to financial hardship, Z91.A98 — Caregiver's noncompliance with patient's other medical treatment and regimen for other reason, Z91.B — Personal risk factor of exposure to diethylstilbestrol, Z93.1 — Gastrostomy status, Z93.2 — Ileostomy status, Z93.3 — Colostomy status, Z93.4 — Other artificial openings of gastrointestinal tract status, Z93.50 — Unspecified cystostomy status, Z93.51 — Cutaneous-vesicostomy status, Z93.52 — Appendico-vesicostomy status, Z93.59 — Other cystostomy status, Z93.6 — Other artificial openings of urinary tract status, Z93.8 — Other artificial opening status, +232 more

Same Index main term, other category

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

Z90.411 — Acquired partial absence of pancreas (pancreatectomy, partial), Z90.49 — Acquired absence of other specified parts of digestive tract (colectomy), Z90.5 — Acquired absence of kidney (nephrectomy), Z90.6 — Acquired absence of other parts of urinary tract (cystectomy), Z90.710 — Acquired absence of both cervix and uterus (hysterectomy), Z90.711 — Acquired absence of uterus with remaining cervical stump (hysterectomy, partial), Z90.721 — Acquired absence of ovaries, unilateral (oophorectomy, unilateral), Z90.722 — Acquired absence of ovaries, bilateral (oophorectomy, bilateral), Z90.81 — Acquired absence of spleen (splenectomy), Z92.82 — Status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility (tPAadministration in a different facility within the last 24 hours prior to admission to current facility), Z95.0 — Presence of cardiac pacemaker (pacemaker, cardiac), Z95.1 — Presence of aortocoronary bypass graft (aortocoronary bypass), Z95.2 — Presence of prosthetic heart valve (organ replacement, by artificial or mechanical device or prosthesis of, heart, valve), Z95.5 — Presence of coronary angioplasty implant and graft (prosthesis coronary angioplasty), Z95.812 — Presence of fully implantable artificial heart (organ replacement, by artificial or mechanical device or prosthesis of, heart), Z95.820 — Peripheral vascular angioplasty status with implants and grafts (angioplasty, with implant), Z95.828 — Presence of other vascular implants and grafts (organ replacement, by artificial or mechanical device or prosthesis of, artery), Z96.0 — Presence of urogenital implants (organ replacement, by artificial or mechanical device or prosthesis of, bladder), Z96.1 — Presence of intraocular lens (pseudophakia), Z96.3 — Presence of artificial larynx (organ replacement, by artificial or mechanical device or prosthesis of, larynx), +71 more

Contextual Map

Every relationship of Z93.0 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 Z93.0 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes2 notes (12)

Referenced by Use Additional Code instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 211 — Respirator Dependence/Tracheostomy Status/Complications [CMS-HCC]: “Respirator Dependence/Tracheostomy Status/Complications — supersedes HCC 212 (Respiratory Arrest), HCC 213 (Cardio-Respiratory Failure and Shock)”— CMS-HCC V28 · 2026

MS-DRG Grouper

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

  • Artificial, opening status (functioning) (without complication), tracheostomy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Status (post), tracheostomy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Tracheostomy, status[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (13)

Change history

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

Common coding questions

Can Z93.0 be a principal diagnosis?

No, not on a Medicare inpatient claim — Z93.0 is on the Medicare Code Editor’s unacceptable-principal-diagnosis list (MCE v43.1, edit 09), so the Medicare Code Editor flags an IPPS claim with it sequenced first under that edit rather than accepting it as principal. The ICD-10-CM guidelines themselves do not forbid it, but the Excludes1 note on category Z93 sends any encounter that is actually about the tracheostomy to Z43.0 or to J95.0- instead. The full status-versus-attention logic is worked through in When can a Z code be the primary diagnosis?.

Z93.0 or Z43.0 for tracheostomy care?

Z43.0. Z93.0 states only that the patient has a tracheostomy; the moment the encounter involves cleaning, tube change, or closure, category Z43’s Includes note claims it and Z93’s Excludes1 (“artificial openings requiring attention or management (Z43.-)”) bars Z93.0 from the claim. Report Z93.0 as a secondary code only when the tracheostomy is incidental to an encounter for something else.

Does Z93.0 map to an HCC for risk adjustment?

Yes. Under CMS-HCC V28 (payment year 2026), Z93.0 maps to HCC 211, Respirator Dependence/Tracheostomy Status/Complications, which suppresses HCC 212 (Respiratory Arrest) and HCC 213 (Cardio-Respiratory Failure and Shock) when captured; under the older V22 model it maps to HCC 82. Z93.0 is the outlier in its family — every other billable Z93.x code maps to V28 HCC 463 (Artificial Openings for Feeding or Elimination) — so dropping it loses risk capture the sibling codes would not.

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
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "Z93.0 — Tracheostomy status." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/z93.0-tracheostomy-status

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Tracheostomy status

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 Z93.0 in its code family, with their registry titles.

View all codes in the Z93 family