Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis. Exempt from present-on-admission (POA) reporting.
Excludes1 (never code together)
artificial heart status (Z95.812)
heart-valve replacement status (Z95.2-Z95.4)
Applies from Z94 Transplanted organ and tissue status
Includes
organ or tissue replaced by heterogenous or homogenous transplant
Excludes1 (never code together)
complications of transplanted organ or tissue - see Alphabetical Index
CMS-HCC V22: HCC 186 — Major Organ Transplant or Replacement Status
RxHCC V08: HCC 396 — Heart, Lung, Liver, Intestine, or Pancreas Transplant Status
ESRD V24: HCC 186
MS-DRG index
Defines the logic of DRG(s) 314-316 in MDC 05.
Approximate ICD-9-CM (GEMs)
V42.1 Heart replaced by transplant (approximate)
Medicare Code Edits (MCE v43.1 (April 2026))
Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.
Code annotations containing back-references to Z94.1
Back-references to Z94
Type 1 Excludes: Z18 Retained foreign body fragments ("organ or tissue replaced by transplant (Z94.-)")
Type 2 Excludes: Z78 Other specified health status ("postprocedural status (Z93-Z99)")
Type 2 Excludes: Z87.7 Personal history of (corrected) congenital malformations ("transplanted organ and tissue status (Z94.-)")