Z95.1 ICD-10-CM Code: Presence of aortocoronary bypass graft
Z95.1 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
Z95.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePresence of aortocoronary bypass graft
A patient who has had a bypass graft surgically placed to reroute blood flow around a blocked artery in the heart.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Presence of coronary artery bypass graft
Excludes 2
Official- complications of cardiac and vascular devices, implants and grafts (T82.-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z95.1 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z95.1 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z95.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z95.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z95.1 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is Z95.1 an HCC code?
No. Z95.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Z95.1
- Description
- Presence of aortocoronary bypass graft
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z95.1 is the ICD-10-CM diagnosis code for presence of aortocoronary bypass graft. A patient who has had a bypass graft surgically placed to reroute blood flow around a blocked artery in the heart. Z95.1 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons with potential health hazards related to family and personal history and certain conditions influencing health status (z77-z99).
Z95.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code for aortocoronary bypass grafts (CABG); document the number of grafts if multiple are present for more specific coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z95.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for aortocoronary bypass grafts (CABG); document the number of grafts if multiple are present for more specific coding
- •This is a status code indicating a past surgical procedure; it should not be used as a primary diagnosis unless the bypass graft is the focus of current treatment