W94.11XA ICD-10-CM Code: Exposure to residence or prolonged visit at high altitude, initial encounter

W94.11XA is the ICD-10-CM diagnosis code for exposure to residence or prolonged visit at high altitude, initial encounter. W94.11XA sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering exposure to electric current, radiation and extreme ambient air temperature and pressure (w85-w99).

W94.11XA 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.

W94.11XA 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 W94.11XA 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.