Z87.762
BillablePersonal history of (corrected) prune belly malformation
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z87.762 an HCC code?
No. Z87.762 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
Z87.762 is the ICD-10-CM diagnosis code for personal history of (corrected) prune belly malformation. A person who previously had prune belly syndrome, a rare birth defect characterized by underdeveloped abdominal muscles and urinary tract abnormalities, that has been surgically corrected. Z87.762 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).
Z87.762 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.
Prune belly is a rare condition; ensure detailed documentation of the specific malformations that were present and corrected.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z87.762 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Prune belly is a rare condition; ensure detailed documentation of the specific malformations that were present and corrected
- •Monitor for associated urological complications even after surgical correction