Y07.499
BillableOther family member, 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 Y07.499 an HCC code?
No. Y07.499 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
Y07.499 is the ICD-10-CM diagnosis code for other family member, perpetrator of maltreatment and neglect. Another family member not specifically listed is identified as the person who caused maltreatment or neglect to an individual. Y07.499 sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering assault (x92-y09).
Y07.499 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 as a catch-all for family members who don't fit into the more specific Y07 categories.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Y07.499 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code as a catch-all for family members who don't fit into the more specific Y07 categories
- •Document the specific relationship of the perpetrator in the medical record for clarity