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Z65.4 ICD-10-CM Code: Victim of crime and terrorism

Z65.4 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)

Z65.4

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Victim of crime and terrorism

A person has been a victim of crime or terrorism and may be experiencing physical, emotional, or psychological effects from this experience.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
Z65Problems related to other psychosocial circumstances
Z65.4Victim of crime and terrorism

Inclusion Terms

Official
  • Victim of torture

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z65.4 in this effective period.

Related Child Codes

Official
Z65.0Conviction in civil and criminal proceedings without imprisonment
Z65.1Imprisonment and other incarceration
Z65.2Problems related to release from prison
Z65.3Problems related to other legal circumstances
Z65.5Exposure to disaster, war and other hostilities

Includes

Official

ICD-10-CM does not list Includes notes for Z65.4 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Z65.4 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Z65.4 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z65.4 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z65.4 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Use this code when victimization is documented and relevant to the patient's current health status or treatment
Consider coding related mental health conditions (PTSD, anxiety, depression) separately if present

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is Z65.4 an HCC code?

No. Z65.4 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
Z65.4
Description
Victim of crime and terrorism
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
Yes
Payment year
2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Z65.4 is the ICD-10-CM diagnosis code for victim of crime and terrorism. A person has been a victim of crime or terrorism and may be experiencing physical, emotional, or psychological effects from this experience. Z65.4 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons with potential health hazards related to socioeconomic and psychosocial circumstances (z55-z65).

Z65.4 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.

Use this code when victimization is documented and relevant to the patient's current health status or treatment.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z65.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code when victimization is documented and relevant to the patient's current health status or treatment
  • Consider coding related mental health conditions (PTSD, anxiety, depression) separately if present

Child Codes

Code Hierarchy

Work Z65.4 in HCC Buddy

Open Z65.4 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.