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Z89.219

Billable

Acquired absence of unspecified upper limb below elbow

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is Z89.219 an HCC code?

No. Z89.219 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

Z89.219 is the ICD-10-CM diagnosis code for acquired absence of unspecified upper limb below elbow. The person has lost their forearm and hand below the elbow, but the documentation does not specify whether it is the right or left side. Z89.219 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).

Z89.219 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 only when the amputation level is clearly below the elbow but laterality is not documented.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z89.219 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use only when the amputation level is clearly below the elbow but laterality is not documented
  • Query the provider to determine laterality for more precise coding when possible

Code Hierarchy

More on Z89.219

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