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

ICD-10 Z96.649

Billable / Specific

Presence of unspecified artificial hip joint

Z96
Block
0
Synonyms
100
LCDs
4
Payer Policies
0
Linked CPTs

About ICD-10-CM Z96.649

ICD-10-CM code Z96.649 represents Presence of unspecified artificial hip joint. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z96). The 2026 edition of ICD-10-CM Z96.649 became effective on October 1, 2025.

Medicare LCD Coverage for Z96.649

Local Coverage Determinations (LCDs) from CMS MACs that list Z96.649 as a covered diagnosis.

100 LCDs

Showing top 10 of 100 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27134 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27130 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27487 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27137 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27486 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27138 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27132 →
CMS LCD: Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Article ID: 56796, Effective: 2026-01-01 00:00:00, 1355 covered, 1 non-covered
CPT 27447 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 29131 →
CMS LCD: Billing and Coding: Outpatient Occupational Therapy
Article ID: 53064, Effective: 2026-01-01 00:00:00, 8021 covered, 0 non-covered
CPT 29260 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing Z96.649.

4 policies

3 Medicare

Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Lower Extremity Major Joint Replacement (Hip and Knee)
Policy ID: ART-56796
Billing and Coding: Major Joint Replacement (Hip and Knee)
Policy ID: ART-57765

1 Aetna

Hip Arthroplasty
Policy ID: CPB-0287

CPT Codes Commonly Billed with Z96.649

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

No procedure linkages on file for Z96.649

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert Z96.649 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
Z96.649 V4364 10000

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

Codes Adjacent To Z96.649

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 Z96.649, Billing FAQ

Is ICD-10 code Z96.649 billable? +

Yes, Z96.649 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does Z96.649 map to? +

Per CMS GEMs, Z96.649 maps to ICD-9 codes: V4364. 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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