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Z97.1 ICD-10-CM Code: Presence of artificial limb (complete) (partial)

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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 Excludes1 · 2 Excludes2 · 1 code-also instruction

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for Z97.1 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 Z97.1 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 Z97

Excludes2 — Not Included Here

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

Source: inherited from Z97

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 Z97.1

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

Before you code Z97.1

  1. Z97.1 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).

    ReviewZ97.10, Z97.11, Z97.12, Z97.13, Z97.14, Z97.15, Z97.16

    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) →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with Z97.1. 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 one of the more specific codes beneath Z97.1?
    Yes → Select that code and continue the checks below on its own page.
    No → Z97.1 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewZ97.10, Z97.11, Z97.12, Z97.13, Z97.14, Z97.15, Z97.16

  2. Does the documentation support a condition named in Z97.1’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.

Consider Z97.1. 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 Z97.1(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with Z97.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

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

  • Excludes2 — not part of Z97.1(2 notes)

    Coding workflow: The conditions named in this note are not included in Z97.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareZ98.2

    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

Coding decision scenarios

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

Documentation: Both the condition Z97.1 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).

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.

Coding context

The comparisons, hierarchy, index entries, guidelines, relationships, risk-adjustment and coverage context a coder commonly needs. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Don’t confuse Z97.1 with…

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

The codes most likely to be picked instead of Z97.1 — 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.

  • T82— 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 complications of internal prosthetic devices, implants and grafts moves the case to T82; the two are not reported together unless documented as unrelated.

    Full comparison: Z97.1 vs T82 →

  • T85— 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 complications of internal prosthetic devices, implants and grafts moves the case to T85; the two are not reported together unless documented as unrelated.

    Full comparison: Z97.1 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: Z97.1 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: Z97.1 vs Z46 →

  • Z98.2— 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 presence of cerebrospinal fluid drainage device adds Z98.2; it is not part of this code and both may be reported when both are documented.

    Full comparison: Z97.1 vs Z98.2 →

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.

Code Overview

Presence of artificial limb (complete) (partial) is a non-billable ICD-10-CM category code (Z97.1). 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.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

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 Z97.1 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 Z97.-), Z44 — Encounter for fitting and adjustment of external prosthetic device (via Z97.-).

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 Z97.-), Z45.018 — Encounter for adjustment and management of other part of cardiac pacemaker (via Z97.-), Z46 — Encounter for fitting and adjustment of other devices (via Z97.-), Z78 — Other specified health status (via Z97.-), Z87.7 — Personal history of (corrected) congenital malformations (via Z97.-).

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

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.

Z96.41 — Presence of insulin pump (external) (internal) (insulin pump), Z96.49 — Presence of other endocrine implants (endocrine implant NEC), Z96.5 — Presence of tooth-root and mandibular implants (tooth rootimplant), Z96.60 — Presence of unspecified orthopedic joint implant (joint implant), Z96.61 — Presence of artificial shoulder joint (shoulder-joint implant), Z96.62 — Presence of artificial elbow joint (elbow-joint implant), Z96.63 — Presence of artificial wrist joint (wrist-joint implant), Z96.64 — Presence of artificial hip joint (hip-joint implant), Z96.65 — Presence of artificial knee joint (knee-joint implant), Z96.66 — Presence of artificial ankle joint (ankle-joint implant), Z96.69 — Presence of other orthopedic joint implants (finger-joint implant), Z96.698 — Presence of other orthopedic joint implants (joint implant, specified joint NEC), Z96.7 — Presence of other bone and tendon implants (tendon implant), Z96.81 — Presence of artificial skin (implanted device, skin), Z96.82 — Presence of neurostimulator (neurostimulator), Z96.89 — Presence of other specified functional implants (implanted device, specified NEC), Z96.9 — Presence of functional implant, unspecified (implanted device), Z98.0 — Intestinal bypass and anastomosis status (intestinal bypass or anastomosis), Z98.2 — Presence of cerebrospinal fluid drainage device (CSF shunt), Z99.2 — Dependence on renal dialysis (arterial-venous shunt), +21 more

Contextual Map

Every relationship of Z97.1 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 Z97.1 with these 7 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Nearest codes (14)

Change history

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

Deep reference

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 Z97.1 be billed directly?

No. Z97.1 (Presence of artificial limb (complete) (partial)) 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 20, 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. "Z97.1 — Presence of artificial limb (complete) (partial)." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/z97.1-presence-of-artificial-limb-complete-partial

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Presence of artificial limb (complete) (partial)

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 Z97.1 in its code family, with their registry titles.

View all codes in the Z97 family