Z87.441
BillablePersonal history of nephrotic syndrome
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z87.441 an HCC code?
No. Z87.441 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
Z87.441 is the ICD-10-CM diagnosis code for personal history of nephrotic syndrome. A patient's past history of nephrotic syndrome, a kidney condition characterized by protein loss in urine that has been treated or resolved. Z87.441 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).
Z87.441 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.
Nephrotic syndrome is a serious kidney condition; ensure documentation clearly indicates it is resolved or in remission.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z87.441 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Nephrotic syndrome is a serious kidney condition; ensure documentation clearly indicates it is resolved or in remission
- •This history code should be used alongside current kidney function assessments if applicable