ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 Z94.0

Billable / Specific CC

Kidney transplant status

Z94
Block
0
Synonyms
1,068
LCDs
53
Payer Policies
6
Linked CPTs

About ICD-10-CM Z94.0

ICD-10-CM code Z94.0 represents Kidney transplant status. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z94). The 2026 edition of ICD-10-CM Z94.0 became effective on October 1, 2025.

Coding Tips for Z94.0

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

Z94.0 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Kidney transplant status. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for Z94.0

Local Coverage Determinations (LCDs) from CMS MACs that list Z94.0 as a covered diagnosis.

1,068 LCDs

Showing top 10 of 1,068 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Magnesium
Article ID: 59186, Effective: 2025-10-01 00:00:00, 4358 covered, 0 non-covered
CPT 83735 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z94.0.

53 policies

2 Aetna

Color-Flow Doppler Echocardiography and Myocardial Strain Imaging - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0008
Hepatitis A Vaccine - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0048

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

5 Medicare

Immunosuppressive Drugs - Policy Article
Policy ID: ART-52474
Billing and Coding: Retroperitoneal Ultrasound
Policy ID: ART-55336
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Assays for Vitamins and Metabolic Function
Policy ID: ART-56416
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421

CPT Codes Commonly Billed with Z94.0

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

6 linkages
  • 87507 CMS LCD: Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) CMS LCD
  • 87505 CMS LCD: Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) CMS LCD
  • 87506 CMS LCD: Billing and Coding: Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs) CMS LCD
  • 0544U CMS LCD: Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection CMS LCD
  • 0509U CMS LCD: Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection CMS LCD
  • 0508U CMS LCD: Billing and Coding: MolDX: Molecular Testing for Solid Organ Allograft Rejection CMS LCD

Convert Z94.0 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
Z94.0 V420 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To Z94.0

Other codes in section Z77-Z99 (Persons with potential health hazards related to family and personal history and certain conditions influencing health status).

Z77 Other contact with and (suspected) exposures hazardous to health (non-billable) Z77.0 Contact with and (suspected) exposure to hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.01 Contact with and (suspected) exposure to hazardous metals (non-billable) Z77.010 Contact with and (suspected) exposure to arsenic Z77.011 Contact with and (suspected) exposure to lead Z77.012 Contact with and (suspected) exposure to uranium Z77.018 Contact with and (suspected) exposure to other hazardous metals Z77.02 Contact with and (suspected) exposure to hazardous aromatic compounds (non-billable) Z77.020 Contact with and (suspected) exposure to aromatic amines Z77.021 Contact with and (suspected) exposure to benzene Z77.028 Contact with and (suspected) exposure to other hazardous aromatic compounds Z77.09 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals (non-billable) Z77.090 Contact with and (suspected) exposure to asbestos Z77.098 Contact with and (suspected) exposure to other hazardous, chiefly nonmedicinal, chemicals Z77.1 Contact with and (suspected) exposure to environmental pollution and hazards in the physical environment (non-billable) Z77.11 Contact with and (suspected) exposure to environmental pollution (non-billable) Z77.110 Contact with and (suspected) exposure to air pollution Z77.111 Contact with and (suspected) exposure to water pollution Z77.112 Contact with and (suspected) exposure to soil pollution Z77.118 Contact with and (suspected) exposure to other environmental pollution

ICD-10 Z94.0, Billing FAQ

Is ICD-10 code Z94.0 billable? +

Yes, Z94.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is Z94.0 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with Z94.0? +

Procedures frequently paired with Z94.0 include: 87507, 87505, 87506, 0544U, 0509U.

What ICD-9 codes does Z94.0 map to? +

Per CMS GEMs, Z94.0 maps to ICD-9 codes: V420. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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