T87.0X1 ICD-10-CM Code: Complications of reattached (part of) right upper extremity
T87.0X1 maps to CMS-HCC V28 405 (RAF 0.598). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools
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FY 2026 Apr update / Injury, poisoning and certain other consequences of external causes (S00-T88) / Complications of surgical and medical care, not elsewhere classified (T80-T88)
T87.0X1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceComplications of reattached (part of) right upper extremity
Problems or complications that occur after a right arm or hand (or part of it) has been surgically reattached following amputation or traumatic loss.
Buddy Insight
Complications of reattached right upper extremity indicate problems with a surgically reattached arm or hand, potentially including infection, necrosis, or failure of reattachment.
CMS-HCC V28
MappedHCC 405
RAF 0.598
CMS-HCC V24
MappedHCC 173
RAF 0.208
ACA/HHS
MappedHCC 234
Varies by metal level
ESRD/PACE
MappedHCC 173
RAF 0.050
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for T87.0X1 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for T87.0X1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for T87.0X1 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for T87.0X1 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for T87.0X1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for T87.0X1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for T87.0X1 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 T87.0X1 an HCC code?
Yes. T87.0X1 (Complications of reattached (part of) right upper extremity) maps to Traumatic Amputations and Complications under the CMS-HCC V28 risk adjustment model (and Traumatic Amputations and Complications under V24), with a community non-dual aged RAF of 0.598. It is billable for payment year 2026.
Coder answer: T87.0X1 is billable and maps to V28 HCC 405, Traumatic Amputations and Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- T87.0X1
- Description
- Complications of reattached (part of) right upper extremity
- HCC (V28)
- HCC 405 — Traumatic Amputations and Complications
- RAF
- 0.598
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work T87.0X1 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for T87.0X1
For T87.0X1 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed T87.0X1 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
T87.0X1 is the ICD-10-CM diagnosis code for complications of reattached (part of) right upper extremity. Problems or complications that occur after a right arm or hand (or part of it) has been surgically reattached following amputation or traumatic loss. T87.0X1 sits in the ICD-10-CM chapter for injury, poisoning and certain other consequences of external causes (s00-t88), within the section covering complications of surgical and medical care, not elsewhere classified (t80-t88).
Under the CMS-HCC V28 risk adjustment model, T87.0X1 maps to Traumatic Amputations and Complications (HCC 405) with a community, non-dual, aged base RAF weight of 0.598. Under the older V24 model, T87.0X1 mapped to the same category but with a base RAF weight of 0.208, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
The 'X' in the code structure allows for additional characters; verify the complete code with the fifth character for specific complication type. Because T87.0X1 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for T87.0X1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •The 'X' in the code structure allows for additional characters; verify the complete code with the fifth character for specific complication type
- •Document whether the complication involves the entire extremity or just a part (finger, hand, etc.) for accurate coding
Clinical Significance
Complications of reattached right upper extremity indicate problems with a surgically reattached arm or hand, potentially including infection, necrosis, or failure of reattachment. These complications can result in functional impairment or need for re-amputation.
Documentation Requirements
- ✓Documentation of traumatic amputation and reattachment procedure
- ✓Specific complications present (infection, necrosis, vascular compromise)
- ✓Right upper extremity laterality clearly specified
- ✓Clinical examination findings supporting complications
- ✓Functional assessment of the reattached limb
- ✓Treatment plans for complication management
- ✓Provider assessment confirming reattachment-related etiology
- ✓Timeline relationship between reattachment and complication
Commonly Confused Codes
- •T87.0X2: complications of reattached left upper extremity (right vs left)
- •T87.0X9: complications of reattached unspecified upper extremity (specified vs unspecified)
- •Z89.11: acquired absence of right hand (complication vs amputation status)
- •S68.111A: complete traumatic amputation right hand (acute injury vs reattachment complication)
- •T87.30: neuroma of amputation stump (reattachment vs amputation complication)