Z87.728
BillablePersonal history of other specified (corrected) congenital malformations of nervous system and sense organs
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z87.728 an HCC code?
No. Z87.728 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
Z87.728 is the ICD-10-CM diagnosis code for personal history of other specified (corrected) congenital malformations of nervous system and sense organs. A patient who had a birth defect of the nervous system or sense organs (other than eye or ear) that has been surgically corrected or resolved, such as spina bifida repair or cleft palate surgery. Z87.728 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).
Z87.728 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 catch-all code for corrected birth defects of the nervous system and sense organs not captured by more specific codes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z87.728 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a catch-all code for corrected birth defects of the nervous system and sense organs not captured by more specific codes
- •Clearly document the specific birth defect and the correction performed for comprehensive medical history