Z52.811 ICD-10-CM Code: Egg (Oocyte) donor under age 35, designated recipient
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)
Z52.811
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEgg (Oocyte) donor under age 35, designated recipient
A woman under age 35 who is donating eggs (oocytes) for fertility treatment where the recipient is known or identified to the donor.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Z52.811 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z52.811 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z52.811 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z52.811 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z52.811 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z52.811 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z52.811 in this effective period.
Buddy Documentation Tip
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 Z52.811 an HCC code?
No. Z52.811 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
Z52.811 is the ICD-10-CM diagnosis code for egg (oocyte) donor under age 35, designated recipient. A woman under age 35 who is donating eggs (oocytes) for fertility treatment where the recipient is known or identified to the donor. Z52.811 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).
Z52.811 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.
Designated recipients may be family members or known individuals; ensure proper documentation of donor-recipient relationship.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z52.811 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Designated recipients may be family members or known individuals; ensure proper documentation of donor-recipient relationship
- •Age of donor at time of donation is critical for correct code selection