A52.76
BillableOther genitourinary symptomatic late syphilis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is A52.76 an HCC code?
No. A52.76 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A52.76 is the ICD-10-CM diagnosis code for other genitourinary symptomatic late syphilis. This code describes syphilis infection that affects the genitourinary system (reproductive and urinary organs) in its late stage, causing various symptoms beyond the primary infection. It represents a sexually transmitted infection that has progressed and is now causing problems in these specific body systems. A52.76 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering infections with a predominantly sexual mode of transmission (a50-a64).
A52.76 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.
Verify documentation specifies 'late syphilis' and genitourinary involvement; do not use this code for early or primary syphilis presentations.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A52.76 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies 'late syphilis' and genitourinary involvement; do not use this code for early or primary syphilis presentations
- •Ensure the clinical record documents specific genitourinary symptoms (such as urethritis, cystitis, or reproductive organ involvement) to justify this code selection rather than more general late syphilis codes