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T87.30 ICD-10-CM Code: Neuroma of amputation stump, unspecified extremity

T87.30 maps to CMS-HCC V28 409. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC coding software

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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)

T87.30

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

Neuroma of amputation stump, unspecified extremity

A painful nerve growth (neuroma) that develops at the site where a limb was amputated, when the specific limb location is not specified.

Buddy the Bee presenting code insight

Buddy Insight

Neuroma of amputation stump in unspecified extremity represents painful nerve growth at amputation sites that can cause significant disability and impact prosthetic use.

CMS-HCC V28

HCC 409

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 234

Code-level coefficient reference

ESRD/PACE

HCC 189

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
T87Complications peculiar to reattachment and amputation
T87.3Neuroma of amputation stump
T87.30Neuroma of amputation stump, unspecified extremity

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for T87.30 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for T87.30 in this effective period.

Related Child Codes

Official
T87.31Neuroma of amputation stump, right upper extremity
T87.32Neuroma of amputation stump, left upper extremity
T87.33Neuroma of amputation stump, right lower extremity
T87.34Neuroma of amputation stump, left lower extremity

Includes

Official

ICD-10-CM does not list Includes notes for T87.30 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for T87.30 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for T87.30 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for T87.30 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for T87.30 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of previous amputation procedure
Clinical evidence of neuroma formation
Pain characteristics and location at stump site
Physical examination findings consistent with neuroma

MEAT Support

HCC Buddy guidance
Documentation of previous amputation procedure
Clinical evidence of neuroma formation
Pain characteristics and location at stump site
Physical examination findings consistent with neuroma

Audit Caution

HCC Buddy guidance
Using when specific extremity location is documented
Not establishing clear relationship to amputation
Confusing with general neuropathy or pain conditions
Missing amputation history documentation

Common Mistakes

HCC Buddy guidance
T87.31-T87.33 — neuroma of specified extremity (unspecified vs specific location)
M79.2 — neuralgia and neuritis unspecified (amputation stump vs general neuralgia)
G58.9 — mononeuropathy unspecified (neuroma vs general neuropathy)
T87.40-T87.44 — infection of amputation stump (neuroma vs infection)

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 T87.30 an HCC code?

Yes. T87.30 (Neuroma of amputation stump, unspecified extremity) maps to HCC 409, Amputation Status, Lower Limb/Amputation Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.598. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: T87.30 is billable and maps to V28 HCC 409, Amputation Status, Lower Limb/Amputation Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
T87.30
Description
Neuroma of amputation stump, unspecified extremity
HCC (V28)
HCC 409 — Amputation Status, Lower Limb/Amputation Complications
RAF reference coefficient
0.598
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 409, Amputation Status, Lower Limb/Amputation Complications
0.598
ESRDHCC 189, Amputation Status/Lower Limb/Amputation Complications
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work T87.30 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for T87.30

For T87.30 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 T87.30 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

T87.30 is the ICD-10-CM diagnosis code for neuroma of amputation stump, unspecified extremity. A painful nerve growth (neuroma) that develops at the site where a limb was amputated, when the specific limb location is not specified. T87.30 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, T87.30 maps to Amputation Status, Lower Limb/Amputation Complications (HCC 409) with a source-labeled community, non-dual, aged reference coefficient of 0.598. No V24 mapping is shown for T87.30; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Neuromas are common complications of amputation and may require additional treatment or pain management. Because T87.30 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for T87.30 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Neuromas are common complications of amputation and may require additional treatment or pain management
  • •Always attempt to identify the specific extremity (upper or lower, right or left) to use more specific codes T87.31-T87.39

Clinical Significance

Neuroma of amputation stump in unspecified extremity represents painful nerve growth at amputation sites that can cause significant disability and impact prosthetic use. This condition requires specialized pain management and may need surgical intervention.

Documentation Requirements

  • ✓Documentation of previous amputation procedure
  • ✓Clinical evidence of neuroma formation
  • ✓Pain characteristics and location at stump site
  • ✓Physical examination findings consistent with neuroma
  • ✓Impact on prosthetic fitting or use
  • ✓Rationale for unspecified extremity designation
  • ✓Treatment attempts or plans for neuroma management
  • ✓Provider assessment confirming neuroma diagnosis

Commonly Confused Codes

  • •T87.31-T87.33: neuroma of specified extremity (unspecified vs specific location)
  • •M79.2: neuralgia and neuritis unspecified (amputation stump vs general neuralgia)
  • •G58.9: mononeuropathy unspecified (neuroma vs general neuropathy)
  • •T87.40-T87.44: infection of amputation stump (neuroma vs infection)
  • •M25.50: pain in unspecified joint (stump pain vs joint pain)

Child Codes

T87.30Neuroma of amputation stump, unspecified extremity
HCC 409
T87.31Neuroma of amputation stump, right upper extremity
HCC 409
T87.32Neuroma of amputation stump, left upper extremity
HCC 409
T87.33Neuroma of amputation stump, right lower extremity
HCC 409
T87.34Neuroma of amputation stump, left lower extremity
HCC 409

Code Hierarchy

└T87Complications peculiar to reattachment and amputation└T87.3Neuroma of amputation stump└T87.30Neuroma of amputation stump, unspecified extremity
└T87.30Neuroma of amputation stump, unspecified extremity

Because T87.30 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

T87.30 maps to CMS-HCC V28 category 409, Amputation Status, Lower Limb/Amputation Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for T87.30. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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