Z89.432 ICD-10-CM Code: Acquired absence of left foot
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
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)
Z89.432
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcquired absence of left foot
A person is missing their entire left foot due to amputation, injury, or surgical removal that occurred after birth.
Buddy Insight
Acquired absence of left foot represents a major lower extremity amputation causing severe mobility impairment and functional disability.
CMS-HCC V28
MappedHCC 409
RAF 0.350
CMS-HCC V24
MappedHCC 189
RAF 0.350
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 189
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for Z89.432 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z89.432 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z89.432 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z89.432 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z89.432 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z89.432 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z89.432 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is Z89.432 an HCC code?
Yes. Z89.432 maps to Amputation Status, Lower Limb/Amputation Complications under the CMS-HCC V28 risk adjustment model (and Amputation Status, Lower Limb/Amputation Complications under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for Z89.432
For Z89.432to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed Z89.432 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
Z89.432 is the ICD-10-CM diagnosis code for acquired absence of left foot. A person is missing their entire left foot due to amputation, injury, or surgical removal that occurred after birth. Z89.432 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).
Under the CMS-HCC V28 risk adjustment model, Z89.432 maps to Amputation Status, Lower Limb/Amputation Complications (HCC 409) with a community, non-dual, aged base RAF weight of 0.350. The V24 model used during the PY2024–PY2025 transition mapped Z89.432 the same way and at the same RAF weight. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Confirm complete foot absence versus partial foot amputation to ensure correct code selection. Because Z89.432 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z89.432 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm complete foot absence versus partial foot amputation to ensure correct code selection.
- •Consider documenting the cause of amputation (trauma, diabetes, infection, etc.) in addition to this status code for complete clinical documentation.
Clinical Significance
Acquired absence of left foot represents a major lower extremity amputation causing severe mobility impairment and functional disability. This condition reflects significant underlying disease progression and requires extensive rehabilitation, prosthetic services, and ongoing specialized care management.
Documentation Requirements
- ✓Complete absence of left foot documented
- ✓Acquired nature of amputation specified
- ✓Anatomical level of amputation detailed
- ✓Underlying etiology or medical necessity
- ✓Current prosthetic device and functionality
- ✓Mobility status and ambulatory capacity
- ✓Ongoing rehabilitation needs and progress
- ✓Complication monitoring and management