2025 ICD-10-CM code Z96.1
(Active) Effective Date: N/A Factors influencing health status and contact with health services - Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) Chapter 21: Factors influencing health status and contact with health services (Z00-Z99) Feed
Presence of intraocular lens (pseudophakia).
Modifiers are generally not applicable to Z codes.
Z96.1 itself does not indicate medical necessity for any specific procedure. It serves as a historical marker for the presence of an IOL, which may then influence the medical necessity of other procedures related to the eye.
Clinicians use Z96.1 to indicate the presence of an IOL, which is important for ongoing eye care management.It aids in understanding a patient's ophthalmic history and can influence decisions regarding future treatments or procedures.
- Chapter 21: Factors influencing health status and contact with health services (Z00-Z99)
- Z96: Presence of other functional implants
In simple words: This code means you have an artificial lens in your eye, usually after cataract surgery.
This code indicates the presence of an intraocular lens (IOL), also known as pseudophakia.It is used to document the status of a patient who has undergone cataract surgery and had their natural lens replaced with an artificial one.
Example 1: A patient presents for a routine eye exam.They had cataract surgery five years prior.The physician documents Z96.1 to indicate the presence of the IOL., A patient experiences blurry vision and is diagnosed with a posterior capsule opacification (secondary cataract). The physician notes Z96.1 as part of the patient's medical history, indicating a previous cataract surgery and IOL implantation., A patient with an IOL develops glaucoma.The ophthalmologist documents both the glaucoma and Z96.1, which may be relevant to treatment decisions.
Documentation should clearly indicate the presence of the IOL, ideally including the date of the original cataract surgery.The type of IOL, if known, can also be documented, but is not required for coding Z96.1.
** Z96.1 is a helpful code for tracking the growing number of patients with IOLs and understanding long-term outcomes of cataract surgery. As of today's date, December 2nd, 2024, this information is current. However, medical coding guidelines and regulations can change periodically, so it's important to stay updated with the latest information.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Not applicable.
- Specialties:Ophthalmology, Optometry
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital (if applicable for other related conditions)