Z43.7
BillableEncounter for attention to artificial vagina
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z43.7 an HCC code?
No. Z43.7 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
Z43.7 is the ICD-10-CM diagnosis code for encounter for attention to artificial vagina. A medical visit to check on or adjust a surgically created artificial vagina, typically constructed during gender confirmation surgery or to treat congenital absence of the vagina. Z43.7 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering encounters for other specific health care (z40-z53).
Z43.7 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.
This code is used for routine follow-up care and maintenance of the artificial vagina.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z43.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is used for routine follow-up care and maintenance of the artificial vagina
- •Ensure proper documentation of whether this is post-operative care or long-term maintenance