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Z38.63

Billable

Quadruplet liveborn infant, delivered vaginally

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

Is Z38.63 an HCC code?

No. Z38.63 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

Z38.63 is the ICD-10-CM diagnosis code for quadruplet liveborn infant, delivered vaginally. One of four babies born to the mother during this delivery, delivered through vaginal birth. Z38.63 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons encountering health services in circumstances related to reproduction (z30-z39).

Z38.63 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.

Assign this code to each quadruplet newborn; use it with a fifth character or additional code to identify which quadruplet (first, second, third, or fourth-born).

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z38.63 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Assign this code to each quadruplet newborn; use it with a fifth character or additional code to identify which quadruplet (first, second, third, or fourth-born)
  • This code should be the principal diagnosis for each quadruplet's newborn record

Code Hierarchy

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