Y07.11
BillableBiological father, perpetrator of maltreatment and neglect
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Y07.11 an HCC code?
No. Y07.11 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
Y07.11 is the ICD-10-CM diagnosis code for biological father, perpetrator of maltreatment and neglect. A biological father who has perpetrated maltreatment or neglect against a child or dependent, documented in medical records when abuse is identified. Y07.11 sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering assault (x92-y09).
Y07.11 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.
Use this code when the perpetrator is identified as a biological father and child abuse or neglect is documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Y07.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when the perpetrator is identified as a biological father and child abuse or neglect is documented
- •This is an external cause code (Y-code) and should be used as a secondary code with the primary injury or condition code