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Y65.4

Billable

Failure to introduce or to remove other tube or instrument

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is Y65.4 an HCC code?

No. Y65.4 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

Y65.4 is the ICD-10-CM diagnosis code for failure to introduce or to remove other tube or instrument. A medical tube or instrument was not properly inserted into the patient's body or was not removed when it should have been during a medical procedure. Y65.4 sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering misadventures to patients during surgical and medical care (y62-y69).

Y65.4 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.

Specify which tube or instrument was involved (e.g., catheter, drain, packing) in the medical record documentation.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Y65.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Specify which tube or instrument was involved (e.g., catheter, drain, packing) in the medical record documentation
  • Ensure documentation clearly indicates whether the failure was in introduction or removal of the device

Code Hierarchy

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