Y81.2 ICD-10-CM Code: Prosthetic and other implants, materials and accessory general- and plastic-surgery devices associated with adverse incidents
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FY 2026 Apr update / External causes of morbidity (V00-Y99) / Medical devices associated with adverse incidents in diagnostic and therapeutic use (Y70-Y82)
Y81.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceProsthetic and other implants, materials and accessory general- and plastic-surgery devices associated with adverse incidents
An adverse event or injury caused by artificial implants, replacement materials, or prosthetics used in general or plastic surgery.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Y81.2 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Y81.2 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Y81.2 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Y81.2 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Y81.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Y81.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Y81.2 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is Y81.2 an HCC code?
No. Y81.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Y81.2
- Description
- Prosthetic and other implants, materials and accessory general- and plastic-surgery devices associated with adverse incidents
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Y81.2 is the ICD-10-CM diagnosis code for prosthetic and other implants, materials and accessory general- and plastic-surgery devices associated with adverse incidents. An adverse event or injury caused by artificial implants, replacement materials, or prosthetics used in general or plastic surgery. Y81.2 sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering medical devices associated with adverse incidents in diagnostic and therapeutic use (y70-y82).
Y81.2 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.
Apply when documenting complications from surgical implants, grafts, or prosthetic materials in general or plastic surgery.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Y81.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Apply when documenting complications from surgical implants, grafts, or prosthetic materials in general or plastic surgery
- •Specify the type and location of the implant for comprehensive medical record documentation