Z97.16

Billable

Presence of artificial legs, bilateral (complete) (partial)

HCC Category Mapping

V28HCC 409 — Amputation Status, Lower Limb/Amputation Complications

0.350

What This Code Means

A patient has artificial leg prosthetics on both sides (bilateral), which may be complete or partial replacements.

Coding Tips

•This code specifically indicates bilateral leg prosthetics; do not use Z97.13 and Z97.14 together when Z97.16 applies
•Document the extent of each prosthetic (complete vs. partial) in the medical record for comprehensive care planning

Clinical Significance

This code indicates the presence of bilateral leg prosthetics, representing adaptation to major bilateral limb loss with severe impact on mobility and independence. These patients have the highest complexity prosthetic care needs and require extensive rehabilitation and ongoing medical management.

Documentation Requirements

✓Confirmation of bilateral artificial leg prosthetics
✓Level of amputation for each leg
✓Type of prosthetic devices (matching or different)
✓Functional status with bilateral prosthetics
✓Gait training and mobility status
✓Bilateral fitting and adjustment needs
✓Wheelchair use in addition to prosthetics
✓Complex rehabilitation requirements

Commonly Confused Codes

Z97.13 — Presence of artificial right leg only Z97.14 — Presence of artificial left leg only Z89.619 — Acquired absence of unspecified leg above knee Z73.6 — Limitation of activities due to disability M79.3 — Panniculitis, unspecified

Code Hierarchy

└Z97Presence of other devices └Z97.1Presence of artificial limb (complete) (partial)└Z97.16Presence of artificial legs, bilateral (complete) (partial)

└Z97.16Presence of artificial legs, bilateral (complete) (partial)