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Z96.64 ICD-10-CM Code: Presence of artificial hip joint

Compare with another code for Z96.64Check this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
1 inclusion term · 2 Excludes2 · 1 code-also instruction

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Code alsofrom Z77-Z99May be needed with this code
  • any follow-up examination (Z08-Z09)
Excludes2from Z96Not included here; may be reported together
  • complications of internal prosthetic devices, implants and grafts (T82-T85)
  • fitting and adjustment of prosthetic and other devices (Z44-Z46)
IncludesWhat this code covers
  • Hip-joint replacement (partial) (total)

Where it sits Source: CMS/NCHS

Under:Chapter 21: Factors Influencing Health Status and Contact with Health ServicesZ77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health statusZ96 Presence of other functional implantsZ96.6 Presence of orthopedic joint implants

Codes under Z96.64 (4)

  • Z96.641Presence of right artificial hip jointBillable
  • Z96.642Presence of left artificial hip jointBillable
  • Z96.643Presence of artificial hip joint, bilateralBillable
  • Z96.649Presence of unspecified artificial hip jointBillable

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z96.64 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on Z96.64 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Hip-joint replacement (partial) (total)

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from Z96

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 Z96.64

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

Before you code Z96.64

  1. Z96.64 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewZ96.641, Z96.642, Z96.643, Z96.649

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. 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) →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath Z96.64?
    Yes → Select that code and continue the checks below on its own page.
    No → Z96.64 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewZ96.641, Z96.642, Z96.643, Z96.649

Report the code beneath Z96.64 that the documentation supports, not Z96.64 itself. Then review the Code Also note, and confirm that code is valid for the date of service on its own page.

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

  • Excludes2 — not part of Z96.64(2 notes)

    Coding workflow: The conditions named in this note are not included in Z96.64. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

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

  • 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

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.

Don’t confuse Z96.64 with…

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

The codes most likely to be picked instead of Z96.64 — 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.

  • Z96.60— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Presence of unspecified orthopedic joint implant” takes Z96.60; specificity in the record moves it back here.

    Full comparison: Z96.64 vs Z96.60 →

  • T82— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of complications of internal prosthetic devices, implants and grafts adds T82; it is not part of this code and both may be reported when both are documented.

    Full comparison: Z96.64 vs T82 →

  • T85— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of complications of internal prosthetic devices, implants and grafts adds T85; it is not part of this code and both may be reported when both are documented.

    Full comparison: Z96.64 vs T85 →

  • Z44— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of fitting and adjustment of prosthetic and other devices adds Z44; it is not part of this code and both may be reported when both are documented.

    Full comparison: Z96.64 vs Z44 →

  • Z46— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of fitting and adjustment of prosthetic and other devices adds Z46; it is not part of this code and both may be reported when both are documented.

    Full comparison: Z96.64 vs Z46 →

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.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Presence of artificial hip joint is a non-billable ICD-10-CM category code (Z96.64). A more specific billable subcode must be selected for claims submission.

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

Verify Before Coding

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name Z96.64 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 2 Excludes1 notes: Z18 — Retained foreign body fragments (via Z96.6.-), Z18 — Retained foreign body fragments (via Z96.-).

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

Referenced by 5 Excludes2 notes across 2 chapters: M96 — Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified (via Z96.-), Z45.018 — Encounter for adjustment and management of other part of cardiac pacemaker (via Z96.-), Z46 — Encounter for fitting and adjustment of other devices (via Z96.-), Z78 — Other specified health status (via Z96.-), Z87.7 — Personal history of (corrected) congenital malformations (via Z96.-).

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

Referenced by 8 Use Additional Code instructions across 3 chapters: M97.8 — Periprosthetic fracture around other internal prosthetic joint (via Z96.6.-), T84.018 — Broken internal joint prosthesis, other site (via Z96.6.-), T84.028 — Dislocation of other internal joint prosthesis (via Z96.6.-), T84.038 — Mechanical loosening of other internal prosthetic joint (via Z96.6.-), T84.058 — Periprosthetic osteolysis of other internal prosthetic joint (via Z96.6.-), T84.068 — Wear of articular bearing surface of other internal prosthetic joint (via Z96.6.-), T84.098 — Other mechanical complication of other internal joint prosthesis (via Z96.6.-), Z47.1 — Aftercare following joint replacement surgery (via Z96.6.-).

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

Related Codes

Same Index main term, other category

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

Z95.3 — Presence of xenogenic heart valve (heart valve implant, xenogenic), Z95.4 — Presence of other heart-valve replacement (heart valve implant, specified type NEC), Z95.5 — Presence of coronary angioplasty implant and graft (coronary artery graft or prosthesis), Z95.810 — Presence of automatic (implantable) cardiac defibrillator (ICD), Z95.811 — Presence of heart assist device (heart assist device), Z95.812 — Presence of fully implantable artificial heart (artificial, heart), Z95.818 — Presence of other cardiac implants and grafts (graft, cardiac NEC), Z95.820 — Peripheral vascular angioplasty status with implants and grafts (intravascular implant NEC, peripheral vessel), Z95.828 — Presence of other vascular implants and grafts (graft, vascular NEC), Z95.9 — Presence of cardiac and vascular implant and graft, unspecified (cardiac, implant or graft), Z97.0 — Presence of artificial eye (artificial, eye), Z97.1 — Presence of artificial limb (complete) (partial) (artificial, limb), Z97.15 — Presence of artificial arms, bilateral (complete) (partial) (artificial, limb, arm, bilateral), Z97.16 — Presence of artificial legs, bilateral (complete) (partial) (artificial, limb, leg, bilateral), Z97.2 — Presence of dental prosthetic device (complete) (partial) (dentures), Z97.3 — Presence of spectacles and contact lenses (spectacles), Z97.4 — Presence of external hearing-aid (hearing-aid or device), Z97.5 — Presence of (intrauterine) contraceptive device (intrauterine contraceptive device), Z97.8 — Presence of other specified devices (device NEC), Z98.0 — Intestinal bypass and anastomosis status (intestinal bypass or anastomosis), +6 more

Contextual Map

Every relationship of Z96.64 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 Z96.64 with these 14 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Referenced by Use Additional Code instructions

Nearest codes (40)

Change history

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

Relevant guides

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can Z96.64 be billed directly?

No. Z96.64 (Presence of artificial hip joint) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "Z96.64 — Presence of artificial hip joint." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/z96.64-presence-of-artificial-hip-joint

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Presence of artificial hip joint

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 Z96.64 in its code family, with their registry titles.

View all codes in the Z96 family