Z89.441 ICD-10-CM Code: Acquired absence of right ankle
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)
Z89.441
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceAcquired absence of right ankle
A person is missing their right ankle due to amputation, injury, or surgical removal that occurred after birth.
Buddy Insight
Acquired absence of right ankle represents a major lower extremity amputation typically performed at the ankle level, 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
Basket needed
Code Book Path
Inclusion Terms
Official- Disarticulation of ankle
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for Z89.441 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z89.441 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for Z89.441 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z89.441 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z89.441 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z89.441 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 Z89.441 an HCC code?
Yes. Z89.441 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 Z89.441
For Z89.441to 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 Z89.441 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
Z89.441 is the ICD-10-CM diagnosis code for acquired absence of right ankle. A person is missing their right ankle due to amputation, injury, or surgical removal that occurred after birth. Z89.441 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, Z89.441 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 Z89.441 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.
Distinguish between ankle disarticulation (removal at the ankle joint) and lower leg amputation above the ankle, which uses different codes. Because Z89.441 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 Z89.441 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between ankle disarticulation (removal at the ankle joint) and lower leg amputation above the ankle, which uses different codes.
- •Document the functional impact and any prosthetic fitting or rehabilitation needs for comprehensive care planning.
Clinical Significance
Acquired absence of right ankle represents a major lower extremity amputation typically performed at the ankle level, causing severe mobility impairment and functional disability. This condition indicates advanced pathology requiring extensive prosthetic services and comprehensive rehabilitation management.
Documentation Requirements
- ✓Acquired absence of right ankle joint documented
- ✓Anatomical level specified as ankle amputation
- ✓Underlying cause or medical necessity noted
- ✓Distinction from foot amputation clarified
- ✓Current prosthetic device type and fit
- ✓Functional mobility and ambulation status
- ✓Ongoing rehabilitation services and goals
- ✓Secondary complications and management