Question 1

What is ICD-10 code Z72.810?

Accepted Answer

Z72.810 is the ICD-10-CM diagnosis code for child and adolescent antisocial behavior. A child or adolescent displays behavioral patterns that are socially unacceptable or harmful, such as aggression, rule-breaking, or disregard for others. Z72.810 sits in the ICD-10-CM chapter for factors influencing health status and contact with health services (z00-z99), within the section covering persons encountering health services in other circumstances (z69-z76).

Z72.810 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.

Specify the type of antisocial behavior in documentation when possible (aggression, theft, vandalism).

Question 2

Is Z72.810 an HCC code?

Accepted Answer

No. Z72.810 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 Z72.810 billable?

Accepted Answer

Yes. Z72.810 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. Z72.810 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 Z72.810?

Accepted Answer

Z72.810 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 Z72.810 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 Z72.810?

Accepted Answer

Specify the type of antisocial behavior in documentation when possible (aggression, theft, vandalism) This is distinct from conduct disorder diagnosis codes and represents behavioral risk factors

HCC Buddy Code Card

Z72.810

Is Z72.810 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open Z72.810 in the Interactive Encoder

Z72.810 ICD-10-CM Code: Child and adolescent antisocial behavior

HCC Buddy Code Card

Z72.810

Is Z72.810 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open Z72.810 in the Interactive Encoder