Q71.20
BillableCongenital absence of both forearm and hand, unspecified upper limb
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q71.20 an HCC code?
No. Q71.20 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
Q71.20 is the ICD-10-CM diagnosis code for congenital absence of both forearm and hand, unspecified upper limb. A congenital condition where both the forearm and hand are absent on one upper limb, with the upper arm present. Q71.20 sits in the ICD-10-CM chapter for congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (q00-qa0), within the section covering congenital malformations and deformations of the musculoskeletal system (q65-q79).
Q71.20 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.
The unspecified laterality requires provider clarification - determine if right, left, or bilateral.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q71.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The unspecified laterality requires provider clarification - determine if right, left, or bilateral
- •Distinguish from Q71.10 by confirming that the forearm AND hand are both absent