What is ICD-10 code T87.1X9?

T87.1X9 is the ICD-10-CM diagnosis code for Complications of reattached (part of) unspecified lower extremity. Problems or complications that occur after a leg or foot (or part of it) has been surgically reattached, when it is unclear which side (left or right) is affected. T87.1X9 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. T87.1X9 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. T87.1X9 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. T87.1X9 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for T87.1X9?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For T87.1X9, V28 maps to Traumatic Amputations and Complications at RAF 0.598 while V24 mapped to Traumatic Amputations and Complications at RAF 0.208. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting T87.1X9?

Use this code only when the laterality (left vs. right) cannot be determined from documentation Always attempt to determine and document the specific side affected to use the more specific T87.1X1 or T87.1X2 codes Because T87.1X9 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM T87.1X9: Complications

ICD-10-CM Code View

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Code lookupT87.1X9Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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)

T87.1X9

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Complications of reattached (part of) unspecified lower extremity

Problems or complications that occur after a leg or foot (or part of it) has been surgically reattached, when it is unclear which side (left or right) is affected.

Buddy Insight

Complications of reattached unspecified lower extremity represent documented problems with lower limb reattachment where laterality is not specified.

CMS-HCC V28

Mapped

HCC 405

Traumatic Amputations and Com...

RAF 0.598

CMS-HCC V24

Mapped

HCC 173

Traumatic Amputations and Com...

RAF 0.208

ACA/HHS

Mapped

HCC 234

HHS-HCC 234

Varies by metal level

ESRD/PACE

Mapped

HCC 173

Traumatic Amputations and Com...

RAF 0.050

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

T87.1Complications of reattached (part of) lower extremity

T87.1XComplications of reattached (part of) lower extremity

T87.1X9Complications of reattached (part of) unspecified lower extremity

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for T87.1X9 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for T87.1X9 in this effective period.

Related Child Codes

Official

T87.1X1Complications of reattached (part of) right lower extremity

T87.1X2Complications of reattached (part of) left lower extremity

Includes

Official

ICD-10-CM does not list Includes notes for T87.1X9 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for T87.1X9 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for T87.1X9 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for T87.1X9 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for T87.1X9 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of lower extremity reattachment procedure

Evidence of complications related to reattachment

Rationale for unspecified laterality designation

Clinical findings supporting complication diagnosis

MEAT Support

HCC Buddy guidance

Documentation of lower extremity reattachment procedure

Evidence of complications related to reattachment

Rationale for unspecified laterality designation

Clinical findings supporting complication diagnosis

Audit Caution

HCC Buddy guidance

Using when laterality is documented in the record

Not seeking laterality clarification from providers

Applying to bilateral reattachment complications

Using general amputation codes inappropriately

Common Mistakes

HCC Buddy guidance

T87.1X1 — complications of reattached right lower extremity (unspecified vs right)

T87.1X2 — complications of reattached left lower extremity (unspecified vs left)

Z89.619 — acquired absence of unspecified leg (complication vs status)

T87.30 — neuroma of amputation stump, unspecified extremity (reattachment vs amputation)

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 T87.1X9 an HCC code?

Yes. T87.1X9 (Complications of reattached (part of) unspecified lower 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: T87.1X9 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: T87.1X9
Description: Complications of reattached (part of) unspecified lower extremity
HCC (V28): HCC 405 — Traumatic Amputations and Complications
RAF: 0.598
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 405, Traumatic Amputations and Complications

0.598

V24HCC 173, Traumatic Amputations and Complications

0.208

ESRDHCC 173, Traumatic Amputations and Complications

0.050

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 T87.1X9 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for T87.1X9

For T87.1X9 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 T87.1X9 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

T87.1X9 is the ICD-10-CM diagnosis code for complications of reattached (part of) unspecified lower extremity. Problems or complications that occur after a leg or foot (or part of it) has been surgically reattached, when it is unclear which side (left or right) is affected. T87.1X9 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, T87.1X9 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, T87.1X9 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.

Use this code only when the laterality (left vs. right) cannot be determined from documentation. Because T87.1X9 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 T87.1X9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the laterality (left vs. right) cannot be determined from documentation
•Always attempt to determine and document the specific side affected to use the more specific T87.1X1 or T87.1X2 codes

Clinical Significance

Complications of reattached unspecified lower extremity represent documented problems with lower limb reattachment where laterality is not specified. These complications still carry significant implications for mobility and function requiring specialized care.

Documentation Requirements

✓Documentation of lower extremity reattachment procedure
✓Evidence of complications related to reattachment
✓Rationale for unspecified laterality designation
✓Clinical findings supporting complication diagnosis
✓Functional status and mobility assessment
✓Treatment plans addressing complications
✓Provider assessment confirming reattachment etiology
✓Plans for laterality clarification if feasible

Commonly Confused Codes

•T87.1X1: complications of reattached right lower extremity (unspecified vs right)
•T87.1X2: complications of reattached left lower extremity (unspecified vs left)
•Z89.619: acquired absence of unspecified leg (complication vs status)
•T87.30: neuroma of amputation stump, unspecified extremity (reattachment vs amputation)
•T87.2: complications of other reattached body part (lower extremity vs other)