Z46.3
BillableEncounter for fitting and adjustment of dental prosthetic device
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z46.3 an HCC code?
No. Z46.3 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
Z46.3 is the ICD-10-CM diagnosis code for encounter for fitting and adjustment of dental prosthetic device. A visit to have a dental prosthetic device (such as dentures, bridges, or implants) fitted, adjusted, or replaced. Z46.3 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).
Z46.3 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 applies to prosthetic dental devices only; use different codes for orthodontic devices or routine dental care.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z46.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code applies to prosthetic dental devices only; use different codes for orthodontic devices or routine dental care
- •Document whether the device is being fitted for the first time or adjusted/replaced