Y92.531 ICD-10-CM Code: Health care provider office as the place of occurrence of the external cause
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)
Y92.531
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceHealth care provider office as the place of occurrence of the external cause
An injury or incident that occurred in a healthcare provider's office, such as a doctor's clinic or medical practice.
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- Physician office as the place of occurrence of the external cause
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Y92.531 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Y92.531 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Y92.531 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Y92.531 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Y92.531 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Y92.531 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 Y92.531 an HCC code?
No. Y92.531 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Y92.531
- Description
- Health care provider office as the place of occurrence of the external cause
- 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
Y92.531 is the ICD-10-CM diagnosis code for health care provider office as the place of occurrence of the external cause. An injury or incident that occurred in a healthcare provider's office, such as a doctor's clinic or medical practice. Y92.531 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).
Y92.531 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 when an injury happens during an office visit, not for injuries that occurred before arriving at the office.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Y92.531 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when an injury happens during an office visit, not for injuries that occurred before arriving at the office
- •Common scenarios include falls in waiting rooms or injuries during medical procedures