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Z96.669 ICD-10-CM Code: Presence of unspecified artificial ankle joint

ICD-10-CM Code View

HCC Buddy Code Card

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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)

Z96.669

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Presence of unspecified artificial ankle joint

A patient has an artificial ankle joint, but the specific side (right or left) is not specified or documented. This code is used when laterality cannot be determined.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
Z96.6Presence of orthopedic joint implants
Z96.66Presence of artificial ankle joint
Z96.669Presence of unspecified artificial ankle joint

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for Z96.669 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for Z96.669 in this effective period.

Related Child Codes

Official
Z96.661Presence of right artificial ankle joint
Z96.662Presence of left artificial ankle joint

Includes

Official

ICD-10-CM does not list Includes notes for Z96.669 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for Z96.669 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for Z96.669 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for Z96.669 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for Z96.669 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Only use this code when the medical record does not specify which ankle has the artificial joint
Query the provider if possible to determine laterality, as Z96.661 or Z96.662 would be more specific

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 Z96.669 an HCC code?

No. Z96.669 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

Z96.669 is the ICD-10-CM diagnosis code for presence of unspecified artificial ankle joint. A patient has an artificial ankle joint, but the specific side (right or left) is not specified or documented. This code is used when laterality cannot be determined. Z96.669 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).

Z96.669 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.

Only use this code when the medical record does not specify which ankle has the artificial joint.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Z96.669 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Only use this code when the medical record does not specify which ankle has the artificial joint
  • Query the provider if possible to determine laterality, as Z96.661 or Z96.662 would be more specific

Child Codes

Code Hierarchy

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