Z38.7 ICD-10-CM Code: Other multiple liveborn infant, born outside hospital
HCC Buddy Code Card
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons encountering health services in circumstances related to reproduction (Z30-Z39)
Z38.7
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther multiple liveborn infant, born outside hospital
A newborn from a multiple birth (twins, triplets, or more) who was born outside of a hospital setting.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 247
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- This category is for use as the principal code on the initial record of a newborn baby. It is to be used for the initial birth record only. It is not to be used on the mother's record.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z38.7 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z38.7 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z38.7 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z38.7 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z38.7 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z38.7 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is Z38.7 an HCC code?
No. Z38.7 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- Z38.7
- Description
- Other multiple liveborn infant, born outside hospital
- 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
Z38.7 is the ICD-10-CM diagnosis code for other multiple liveborn infant, born outside hospital. A newborn from a multiple birth (twins, triplets, or more) who was born outside of a hospital setting. Z38.7 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).
Z38.7 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 when delivery location is home, vehicle, or other non-hospital setting.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z38.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use when delivery location is home, vehicle, or other non-hospital setting
- •Document the specific circumstances and any complications from out-of-hospital delivery