Z87.763
BillablePersonal history of other (corrected) congenital abdominal wall malformations
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z87.763 an HCC code?
No. Z87.763 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
Z87.763 is the ICD-10-CM diagnosis code for personal history of other (corrected) congenital abdominal wall malformations. A person who previously had other types of birth defects affecting the abdominal wall (not including gastroschisis or prune belly) that have been surgically corrected. Z87.763 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).
Z87.763 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.
Use this code for abdominal wall malformations such as omphalocele or other defects not specified elsewhere.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z87.763 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for abdominal wall malformations such as omphalocele or other defects not specified elsewhere
- •Document the specific type of abdominal wall malformation in the medical record for clarity