T87.34 ICD-10-CM Code: Neuroma of amputation stump, left lower extremity
T87.34 maps to CMS-HCC V28 409 (RAF 0.598). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC 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)
T87.34
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceNeuroma of amputation stump, left lower extremity
A painful nerve growth (neuroma) that develops at the site of a left leg amputation, causing nerve-related pain and sensitivity.
Buddy Insight
Neuroma of amputation stump represents a significant complication that causes severe neuropathic pain and functional disability, requiring specialized pain management and potentially surgical revision.
CMS-HCC V28
MappedHCC 409
RAF 0.598
CMS-HCC V24
MappedHCC 189
RAF 0.519
ACA/HHS
MappedHCC 234
Varies by metal level
ESRD/PACE
MappedHCC 189
RAF 0.081
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for T87.34 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for T87.34 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for T87.34 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for T87.34 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for T87.34 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for T87.34 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for T87.34 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 T87.34 an HCC code?
Yes. T87.34 (Neuroma of amputation stump, left lower extremity) maps to Amputation Status, Lower Limb/Amputation Complications under the CMS-HCC V28 risk adjustment model (and Amputation Status, Lower Limb/Amputation Complications under V24), with a community non-dual aged RAF of 0.598. It is billable for payment year 2026.
Coder answer: T87.34 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
- T87.34
- Description
- Neuroma of amputation stump, left lower extremity
- HCC (V28)
- HCC 409 — Amputation Status, Lower Limb/Amputation 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 T87.34 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for T87.34
For T87.34 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 T87.34 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
T87.34 is the ICD-10-CM diagnosis code for neuroma of amputation stump, left lower extremity. A painful nerve growth (neuroma) that develops at the site of a left leg amputation, causing nerve-related pain and sensitivity. T87.34 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, T87.34 maps to Amputation Status, Lower Limb/Amputation Complications (HCC 409) with a community, non-dual, aged base RAF weight of 0.598. Under the older V24 model, T87.34 mapped to the same category but with a base RAF weight of 0.519, 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.
Ensure correct laterality (left) is documented in the medical record before coding. Because T87.34 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 T87.34 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure correct laterality (left) is documented in the medical record before coding
- •Consider coding any associated pain separately if it is a significant clinical concern
Clinical Significance
Neuroma of amputation stump represents a significant complication that causes severe neuropathic pain and functional disability, requiring specialized pain management and potentially surgical revision. This diagnosis indicates active post-amputation complications that substantially impact patient quality of life and may prevent prosthetic use.
Documentation Requirements
- ✓Clear documentation of amputation stump location (left lower extremity)
- ✓Clinical evidence of neuroma formation at amputation site
- ✓Pain assessment and characteristics (neuropathic pain patterns)
- ✓Physical examination findings at stump site
- ✓Impact on functional status or prosthetic fitting
- ✓Treatment plan including pain management strategies
- ✓Relationship to previous amputation procedure
- ✓Current symptom severity and duration
Commonly Confused Codes
- •T87.33: Right lower extremity neuroma vs left lower extremity
- •T87.31-T87.32: Upper extremity neuroma vs lower extremity location
- •G89.28: Chronic pain due to trauma, may be coded additionally for pain management
- •T87.44: Infection of amputation stump vs neuroma formation
- •Z89.512: Acquired absence of left leg below knee (status code, not complication)