Watchman Device ICD-10 Code: Z95.818

The ICD-10 code for Watchman device status is Z95.818 (Presence of other cardiac implants and grafts). This code is used to indicate that a patient has a left atrial appendage closure (LAAC) device in place from a prior procedure.

What Is a Watchman Device?

The Watchman is a left atrial appendage closure device used in patients with non-valvular atrial fibrillation who need an alternative to long-term anticoagulation. The device plugs the left atrial appendage to prevent clot formation.

Brand note: "Watchman" is a specific brand (Boston Scientific), but Z95.818 applies to all LAAC devices including Watchman, Amulet, Lariat, and others.

Status Code vs. Procedure Code

This is a critical distinction:

Z95.818 is never used during the implantation admission - it's for subsequent encounters.

Related Z95 Codes

Don't confuse Watchman device status with other cardiac device codes:

Common Coding Scenarios

Scenario 1: Routine Cardiology Follow-Up

Documentation: "Follow-up for AFib management. Watchman device implanted 6 months ago, doing well. Off anticoagulation."

Codes:

• I48.91 (Unspecified atrial fibrillation) or appropriate AFib code - primary
• Z95.818 (Presence of other cardiac implants and grafts) - secondary

Rationale: The AFib is the condition being managed. The Watchman status provides relevant context for why the patient isn't on anticoagulation.

Scenario 2: TEE to Evaluate Device

Documentation: "Transesophageal echo to evaluate Watchman device positioning at 45 days post-implant."

Code: Z95.818 (Presence of other cardiac implants and grafts)

Rationale: When the surveillance of the device is the reason for the encounter, the device status code can be primary.

Scenario 3: Device-Related Complication

Documentation: "Pericardial effusion suspected related to Watchman device implanted 1 week ago."

Codes:

• T82.897A (Other specified complication of cardiac prosthetic devices, implants and grafts, initial encounter)
• I31.3 (Pericardial effusion) - if documented as the complication

Rationale: When a device complication is present, code the complication. T82 codes are for complications of cardiac devices.

Scenario 4: Imaging Finding of Device

Documentation: "CT chest for lung nodule. Incidental Watchman device noted in left atrium."

Code: Don't add Z95.818 unless relevant to care

Rationale: If the Watchman device is only an incidental imaging finding and doesn't affect management of the current encounter, it doesn't need to be coded.

When the Watchman Is Implanted

During the implantation admission:

1. Primary diagnosis: Underlying condition (I48.91 AFib, or Z87.79 if history of stroke for prevention)
2. Procedure code: ICD-10-PCS code for the implantation
3. Do NOT use Z95.818 during the operative admission

Documentation Tips

When documenting Watchman device status:

• Document the device is present (use "Watchman" or "LAAC device")
• Note date of implantation if known
• Indicate current anticoagulation status
• Document any surveillance findings (TEE results, endothelialization)