Question 1

What is ICD-10 code Z52.3?

Accepted Answer

Z52.3 is the ICD-10-CM diagnosis code for bone marrow donor. A person who is donating bone marrow, the tissue inside bones that produces blood cells, for transplantation or medical use. Z52.3 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).

Z52.3 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.

Bone marrow donation is typically used for hematologic malignancies or bone marrow failure conditions.

Question 2

Is Z52.3 an HCC code?

Accepted Answer

No. Z52.3 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is Z52.3 billable?

Accepted Answer

Yes. Z52.3 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. Z52.3 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for Z52.3?

Accepted Answer

Z52.3 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards Z52.3 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting Z52.3?

Accepted Answer

Bone marrow donation is typically used for hematologic malignancies or bone marrow failure conditions Document the method of collection (aspiration vs. peripheral blood stem cell mobilization) if available

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Z52.3

Is Z52.3 an HCC code?

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Z52.3 ICD-10-CM Code: Bone marrow donor

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Z52.3

Is Z52.3 an HCC code?

What This Code Means

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Child Codes

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Open Z52.3 in the Interactive Encoder