Skip to main content

ICD-10-CM Z95.9, Presence of cardiac and vascular implant and graft, unspecified | No Prior Auth

Backwork Sign up free

Ask Backwork/Z95.9

`Z95.9`, Presence of cardiac and vascular implant and graft, unspecified

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information, including complete name and dates of service.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the patient's care.
The submitted medical record must support the use of the selected ICD-10-CM code(s).

Key Coverage Criteria

When billing Medicare Part B for analysis of a Wearable Defibrillator System, report CPT code 93292.
Report CPT codes 93260, 93261, and 93279-93292 when performing the corresponding cardiac rhythm device evaluation procedures (reported per procedure).
Disorders of the carotid artery
Neck trauma
New or worsening neurologic symptoms, including stroke (cerebrovascular attack [CVA]), transient ischemic attack (TIA), amaurosis fugax
Unilateral motor or sensory deficit, and speech impairment

5 Active Policies

NOVITAS-JH-L34833, Cardiac Rhythm Device Evaluation

JH

NOVITAS-JL-L34833, Cardiac Rhythm Device Evaluation

JL

A56602, Billing and Coding: Cardiac Rhythm Device Evaluation

JL

ANTHEM-CG-LAB-21, Serum Iron Testing

CIGNA-0542, Duplex Scan of Extracranial Arteries

Related Codes

I50.9(4 policies)Z95.818(4 policies)I49.9(4 policies)I50.1(4 policies)R00.1(4 policies)Z95.0(4 policies)I42.0(4 policies)93279(3 policies)

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

Ask Backwork about Z95.9 Sign up free

The submitted CPT/HCPCS code must accurately describe the service performed.

Reimbursement is provided only if the requested service is submitted in accordance with the relevant criteria outlined in the Coverage Policy, including a covered diagnosis and/or procedure code.