Z45.018 Encounter for adjustment and management of other part of cardiac pacemaker

Billable ICD-10-CM code, FY2026. Exempt from present-on-admission (POA) reporting.

Excludes1 (never code together)

• presence of other part of cardiac pacemaker (Z95.0)

Excludes2 (not included here)

• presence of prosthetic and other devices (Z95.1-Z95.5, Z95.811-Z97)

Applies from Z45 Encounter for adjustment and management of implanted device

Includes

• removal or replacement of implanted device

Excludes1 (never code together)

• malfunction or other complications of device - see Alphabetical Index

Excludes2 (not included here)

• encounter for fitting and adjustment of non-implanted device (Z46.-)

Applies from Z45.01 Encounter for adjustment and management of cardiac pacemaker

Applicable to

• Encounter for adjustment and management of cardiac resynchronization therapy pacemaker (CRT-P)

Excludes1 (never code together)

• encounter for adjustment and management of automatic implantable cardiac defibrillator with synchronous cardiac pacemaker (Z45.02)

MS-DRG index

Defines the logic of DRG(s) 314-316 in MDC 05.

Approximate ICD-9-CM (GEMs)

• V53.31 Fitting and adjustment of cardiac pacemaker (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Questionable admission: Some diagnoses are not usually sufficient justification for admission to an acute care hospital when reported as principal diagnosis.

Code annotations containing back-references to Z45.018

Back-references to Z45.0

• Type 1 Excludes: Z95.0 Presence of cardiac pacemaker ("adjustment or management of cardiac device (Z45.0-)")
• Type 1 Excludes: Z95.0 Presence of cardiac pacemaker ("adjustment or management of cardiac pacemaker (Z45.0)")

Back-references to Z45

• Type 1 Excludes: Z08 Encounter for follow-up examination after completed treatment for malignant neoplasm ("aftercare following medical care (Z43-Z49, Z51)")
• Type 1 Excludes: Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm ("aftercare following medical care (Z43-Z49, Z51)")
• Type 1 Excludes: Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm ("surveillance of prosthetic and other medical devices (Z44-Z46)")
• Type 2 Excludes: Z43 Encounter for attention to artificial openings ("fitting and adjustment of prosthetic and other devices (Z44-Z46)")
• Type 2 Excludes: Z46 Encounter for fitting and adjustment of other devices ("encounter for fitting and management of implanted devices (Z45.-)")
• Type 2 Excludes: Z48 Encounter for other postprocedural aftercare ("encounter for fitting and adjustment of prosthetic and other devices (Z44-Z46)")
• Type 2 Excludes: Z96 Presence of other functional implants ("fitting and adjustment of prosthetic and other devices (Z44-Z46)")
• Type 2 Excludes: Z97 Presence of other devices ("fitting and adjustment of prosthetic and other devices (Z44-Z46)")
• Type 2 Excludes: Z98 Other postprocedural states ("aftercare (Z43-Z49, Z51)")

Diagnosis Index entries for Z45.018

• Admission (for) › adjustment (of) › device NEC › implanted › cardiac › pacemaker (cardiac resynchronization therapy (CRT-P))
• Admission (for) › adjustment (of) › pacemaker (cardiac resynchronization therapy (CRT-P)) › cardiac
• Cardiac › pacemaker › management or adjustment
• Change (s) (in) (of) › pacemaker
• Checking (of) › cardiac pacemaker (battery) (electrode(s))
• Fitting (and adjustment) (of) › CRT-P (cardiac resynchronization therapy pacemaker)
• Fitting (and adjustment) (of) › pacemaker (cardiac) (cardiac resynchronization therapy (CRT-P))
• Interrogation › cardiac pacemaker
• Management (of) › cardiac pacemaker NEC
• Worn out › cardiac › pacemaker › lead

Nearby codes

• Z45 Encounter for adjustment and management of implanted device
• Z45.0 Encounter for adjustment and management of cardiac device
• Z45.01 Encounter for adjustment and management of cardiac pacemaker
• Z45.010 Encounter for checking and testing of cardiac pacemaker pulse generator [battery]
• Z45.018 Encounter for adjustment and management of other part of cardiac pacemaker (this code)
• Z45.02 Encounter for adjustment and management of automatic implantable cardiac defibrillator
• Z45.09 Encounter for adjustment and management of other cardiac device
• Z45.1 Encounter for adjustment and management of infusion pump
• Z45.2 Encounter for adjustment and management of vascular access device
• Z45.3 Encounter for adjustment and management of implanted devices of the special senses