Z87.731
BillablePersonal history of (corrected) tracheoesophageal fistula or atresia
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z87.731 an HCC code?
No. Z87.731 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
Z87.731 is the ICD-10-CM diagnosis code for personal history of (corrected) tracheoesophageal fistula or atresia. A person who previously had an abnormal connection between the esophagus and trachea (tracheoesophageal fistula) or a missing esophagus opening (atresia) that has been surgically corrected. Z87.731 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).
Z87.731 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.
Document whether the condition was a fistula, atresia, or both in the medical record for clarity.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z87.731 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document whether the condition was a fistula, atresia, or both in the medical record for clarity
- •This code indicates the condition has been repaired; use only for corrected cases