Z49.02 ICD-10-CM Code: Encounter for fitting and adjustment of peritoneal dialysis catheter
HCC Buddy Code Card
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Encounters for other specific health care (Z40-Z53)
Z49.02
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEncounter for fitting and adjustment of peritoneal dialysis catheter
A visit to fit, adjust, or replace a catheter used for peritoneal dialysis (a treatment that uses the abdominal lining to filter waste).
Buddy Insight
This code indicates a patient requires ongoing dialysis for end-stage renal disease with encounters for peritoneal dialysis catheter management, representing severe kidney dysfunction requiring life-sustaining treatment.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
MappedHCC 134
RAF 0.452
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 134
RAF 0.0
RXHCC
MappedHCC 261
RAF 0.0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Encounter for dialysis instruction and training
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z49.02 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z49.02 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z49.02 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z49.02 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z49.02 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z49.02 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 Z49.02 an HCC code?
Yes. Z49.02 maps to Dialysis Status under the V24 model but is not retained in V28.
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.
Work Z49.02 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for Z49.02
For Z49.02to 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 Z49.02 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
Z49.02 is the ICD-10-CM diagnosis code for encounter for fitting and adjustment of peritoneal dialysis catheter. A visit to fit, adjust, or replace a catheter used for peritoneal dialysis (a treatment that uses the abdominal lining to filter waste). Z49.02 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 older CMS-HCC V24 model, Z49.02 maps to Dialysis Status (HCC 134) with a community, non-dual, aged base RAF weight of 0.452. 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 for peritoneal dialysis catheter placement, adjustment, or replacement procedures. Because Z49.02 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 Z49.02 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for peritoneal dialysis catheter placement, adjustment, or replacement procedures
- •Distinguish from hemodialysis codes; peritoneal dialysis uses the peritoneal membrane, not a machine
Clinical Significance
This code indicates a patient requires ongoing dialysis for end-stage renal disease with encounters for peritoneal dialysis catheter management, representing severe kidney dysfunction requiring life-sustaining treatment. Peritoneal dialysis catheter care is essential for maintaining peritoneal access for home-based dialysis therapy.
Documentation Requirements
- ✓Documentation of encounter for peritoneal catheter fitting, adjustment, or maintenance
- ✓Specification of peritoneal dialysis catheter type
- ✓Patient's underlying end-stage renal disease status
- ✓Type of catheter service provided (insertion, adjustment, replacement)
- ✓Peritoneal access site and catheter functionality
- ✓Provider performing catheter management
- ✓Any complications with catheter or peritoneal access
- ✓Ongoing peritoneal dialysis treatment plan
Commonly Confused Codes
- •Z49.01: Use for extracorporeal dialysis catheter instead of peritoneal
- •Z99.2: Use for dependence on renal dialysis status, not catheter encounter
- •T85.691A: Use for peritoneal catheter complications, not routine fitting
- •Z49.32: Use for peritoneal dialysis adequacy testing, not catheter care
- •K91.5: Use for postprocedural complications, not routine catheter management