Z87.438
BillablePersonal history of other diseases of male genital organs
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z87.438 an HCC code?
No. Z87.438 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
Z87.438 is the ICD-10-CM diagnosis code for personal history of other diseases of male genital organs. A patient's past medical history of other diseases affecting the male reproductive organs, such as previous infections, cysts, or other conditions that are no longer active. Z87.438 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 family and personal history and certain conditions influencing health status (z77-z99).
Z87.438 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.
This is a residual code for male genital organ history not captured by more specific codes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z87.438 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a residual code for male genital organ history not captured by more specific codes
- •Clarify in documentation what specific condition is being referenced for better clinical communication