Z19.1
BillableHormone sensitive malignancy status
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z19.1 an HCC code?
No. Z19.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Z19.1 is the ICD-10-CM diagnosis code for hormone sensitive malignancy status. A patient has a history of cancer that responds to hormone therapy treatment. Z19.1 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).
Z19.1 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.
This is a status code used to indicate the patient's cancer is hormone-sensitive; use alongside the primary cancer diagnosis code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z19.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a status code used to indicate the patient's cancer is hormone-sensitive; use alongside the primary cancer diagnosis code
- •Document the type of hormone therapy the patient is receiving or has received for accurate treatment tracking