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Z89.222

Billable

Acquired absence of left upper limb above elbow

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

Is Z89.222 an HCC code?

No. Z89.222 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

Z89.222 is the ICD-10-CM diagnosis code for acquired absence of left upper limb above elbow. A person who has lost their left arm above the elbow due to amputation or other acquired cause, not present from birth. Z89.222 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).

Z89.222 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.

This code is for acquired (not congenital) absence; verify the limb loss was not present at birth.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z89.222 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This code is for acquired (not congenital) absence; verify the limb loss was not present at birth
  • The '222' specifically indicates left upper limb above elbow; ensure laterality is documented in the medical record

Code Hierarchy

More on Z89.222

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