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Z19

Non-Billable (Header)

Hormone sensitivity malignancy status

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

What This Code Means

Z19 is the ICD-10-CM diagnosis code for hormone sensitivity malignancy status. Z19 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering hormone sensitivity malignancy status (z19).

Header codes like Z19 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at Z19's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Code First

  • malignant neoplasm - see Table of Neoplasms, by site, malignant

Child Codes

Code Hierarchy

Z19Hormone sensitivity malignancy status
Z19Hormone sensitivity malignancy status

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