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V43.94XA ICD-10-CM Code: Unspecified car occupant injured in collision with van in traffic accident, initial encounter

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FY 2026 Apr update / External causes of morbidity (V00-Y99) / Car occupant injured in transport accident (V40-V49)

V43.94XA

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

Unspecified car occupant injured in collision with van in traffic accident, initial encounter

Unspecified car occupant injured in collision with van in traffic accident, initial encounter

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
V4394XCar occupant injured in transport accident (V40-V49)
V43.94XAUnspecified car occupant injured in collision with van in traffic accident, initial encounter

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for V43.94XA in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for V43.94XA in this effective period.

Related Child Codes

Official
V43.94XDUnspecified car occupant injured in collision with van in traffic accident, subsequent encounter
V43.94XSUnspecified car occupant injured in collision with van in traffic accident, sequela

Includes

Official

ICD-10-CM does not list Includes notes for V43.94XA in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for V43.94XA in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for V43.94XA in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for V43.94XA in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for V43.94XA in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is V43.94XA an HCC code?

No. V43.94XA 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

V43.94XA is the ICD-10-CM diagnosis code for unspecified car occupant injured in collision with van in traffic accident, initial encounter. V43.94XA sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering car occupant injured in transport accident (v40-v49).

V43.94XA 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.

V43.94XA is a billable ICD-10-CM code that can be reported on claims but does not currently contribute to a Medicare Advantage member's RAF score under any CMS risk adjustment model (V28, V24, ESRD, or RxHCC). Coders reviewing V43.94XA should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for V43.94XA sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

V43.94XAUnspecified car occupant injured in collision with van in traffic accident, initial encounter
V43.94XAUnspecified car occupant injured in collision with van in traffic accident, initial encounter

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