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Z91.49

Billable

Other personal history of psychological trauma, not elsewhere classified

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

Is Z91.49 an HCC code?

No. Z91.49 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

Z91.49 is the ICD-10-CM diagnosis code for other personal history of psychological trauma, not elsewhere classified. A patient's documented history of experiencing psychological trauma or emotional distress that doesn't fit into other specific trauma categories. Z91.49 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).

Z91.49 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 this code when trauma history is documented but doesn't meet criteria for PTSD or other specified trauma disorders.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z91.49 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code when trauma history is documented but doesn't meet criteria for PTSD or other specified trauma disorders
  • This is a history code (Z-code) used for past events that may affect current care or risk assessment

Code Hierarchy

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