Y90.9 ICD-10-CM Code: Presence of alcohol in blood, level not specified
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / External causes of morbidity (V00-Y99) / Supplementary factors related to causes of morbidity classified elsewhere (Y90-Y99)
Y90.9
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePresence of alcohol in blood, level not specified
Documentation that alcohol was present in the blood during testing, but the specific level was not measured or recorded.
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 Y90.9 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Y90.9 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Y90.9 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Y90.9 in this effective period.
Code First
Official- any associated alcohol related disorders (F10)
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Y90.9 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Y90.9 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 Y90.9 an HCC code?
No. Y90.9 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Y90.9
- Description
- Presence of alcohol in blood, level not specified
- 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
Y90.9 is the ICD-10-CM diagnosis code for presence of alcohol in blood, level not specified. Documentation that alcohol was present in the blood during testing, but the specific level was not measured or recorded. Y90.9 sits in the ICD-10-CM chapter for external causes of morbidity (v00-y99), within the section covering supplementary factors related to causes of morbidity classified elsewhere (y90-y99).
Y90.9 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 only when alcohol presence is confirmed but the exact BAC level is unknown or not documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Y90.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when alcohol presence is confirmed but the exact BAC level is unknown or not documented
- •Encourage providers to obtain specific BAC values when possible for more precise coding