Z44.119
BillableEncounter for fitting and adjustment of complete artificial leg, unspecified leg
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z44.119 an HCC code?
Yes. Z44.119 maps to Amputation Status, Lower Limb/Amputation Complications under the CMS-HCC V28 risk adjustment model (and Amputation Status, Lower Limb/Amputation Complications under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for Z44.119
For Z44.119to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed Z44.119 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
Z44.119 is the ICD-10-CM diagnosis code for encounter for fitting and adjustment of complete artificial leg, unspecified leg. A patient visit to have a complete artificial leg (prosthetic) fitted or adjusted when the specific side is not documented or is bilateral. Z44.119 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).
Under the CMS-HCC V28 risk adjustment model, Z44.119 maps to Amputation Status, Lower Limb/Amputation Complications (HCC 409) with a community, non-dual, aged base RAF weight of 0.350. The V24 model used during the PY2024–PY2025 transition mapped Z44.119 the same way and at the same RAF weight. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Use this code only when the prosthetic is confirmed as complete but laterality is not specified. Because Z44.119 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z44.119 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the prosthetic is confirmed as complete but laterality is not specified
- •Query the provider to determine if the fitting is for the right leg, left leg, or both
Clinical Significance
This code indicates a patient has undergone complete lower limb amputation requiring full leg prosthetic management when laterality is unspecified or bilateral. Complete artificial legs represent the most significant level of lower limb prosthetic intervention with complex ongoing care needs.
Documentation Requirements
- ✓Documentation specifying complete artificial leg prosthetic
- ✓Type of encounter (fitting, adjustment, repair, replacement)
- ✓Patient's underlying complete amputation status
- ✓Reason laterality is unspecified or bilateral involvement
- ✓Level of amputation requiring complete prosthetic
- ✓Functional assessment and prosthetic goals
- ✓Provider specialty performing prosthetic services
- ✓Any complications with current complete prosthetic device
Commonly Confused Codes
- •Z44.109 — Use when prosthetic type is unspecified rather than complete
- •Z44.129 — Use when documentation specifies partial rather than complete prosthetic
- •Z44.111/Z44.112 — Use when laterality is clearly documented as right or left
- •Z89.519 — This is amputation status, not prosthetic encounter
- •Z44.00- series — These are for artificial arm prosthetics