Y92.1 ICD-10-CM Code: Institutional (nonprivate) residence as the place of occurrence of the external cause
Y92.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / External causes of morbidity (V00-Y99) / Supplementary factors related to causes of morbidity classified elsewhere (Y90-Y99)
Y92.1
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceInstitutional (nonprivate) residence as the place of occurrence of the external cause
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
Official- The following category is for use, when relevant, to identify the place of occurrence of the external cause. Use in conjunction with an activity code.Inherited from Y92
- Place of occurrence should be recorded only at the initial encounter for treatmentInherited from Y92
Excludes 2
OfficialNo Excludes 2 notes are included in this display for Y92.1. Check the code and parent instructions in the Code Book.
Related Codes
Includes
OfficialNo Includes notes are included in this display for Y92.1. Check the code and parent instructions in the Code Book.
Excludes 1
OfficialNo Excludes 1 notes are included in this display for Y92.1. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for Y92.1. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Y92.1. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for Y92.1. Check the code and parent instructions in the Code Book.
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 →
- Code
- Y92.1
- Description
- Institutional (nonprivate) residence as the place of occurrence of the external cause
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
Y92.1 is the ICD-10-CM diagnosis code for institutional (nonprivate) residence as the place of occurrence of the external cause. Y92.1 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).
Header codes like Y92.1 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Y92.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.