Z89.219 ICD-10-CM Code: Acquired absence of unspecified upper limb below elbow
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FY 2026 Apr update / Factors influencing health status and contact with health services (Z00-Z99) / Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
Z89.219
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcquired 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.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 254
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Z89.219 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z89.219 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z89.219 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z89.219 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z89.219 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z89.219 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z89.219 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
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.
- Code
- Z89.219
- Description
- Acquired absence of unspecified upper limb below elbow
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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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