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Z44.21

Billable

Encounter for fitting and adjustment of artificial right eye

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

Is Z44.21 an HCC code?

No. Z44.21 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

Z44.21 is the ICD-10-CM diagnosis code for encounter for fitting and adjustment of artificial right eye. A patient visit to have an artificial right eye fitted or adjusted for proper alignment and comfort. Z44.21 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).

Z44.21 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.

Ensure documentation clearly indicates the right eye to justify use of this specific code.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z44.21 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Ensure documentation clearly indicates the right eye to justify use of this specific code
  • This code includes both initial fittings and subsequent adjustments or replacements

Code Hierarchy

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