Z97.14
BillablePresence of artificial left leg (complete) (partial)
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Z97.14 an HCC code?
Yes. Z97.14 maps to Amputation Status, Lower Limb/Amputation Complications under the CMS-HCC V28 risk adjustment model.
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 Z97.14
For Z97.14 to 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 Z97.14 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
Z97.14 is the ICD-10-CM diagnosis code for presence of artificial left leg (complete) (partial). A patient has an artificial left leg prosthetic, which may be a complete leg replacement or a partial prosthetic. Z97.14 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, Z97.14 maps to Amputation Status, Lower Limb/Amputation Complications (HCC 409) with a community, non-dual, aged base RAF weight of 0.350. Z97.14 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. 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.
Specify in documentation whether the prosthetic is complete (entire leg) or partial (below-knee, foot, etc.) for clarity. Because Z97.14 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 Z97.14 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify in documentation whether the prosthetic is complete (entire leg) or partial (below-knee, foot, etc.) for clarity
- •Use this code for status documentation; pair with other codes if there are complications or fitting issues
Clinical Significance
This code indicates the presence of a left leg prosthetic device, representing adaptation to major limb loss that significantly impacts mobility and independence. These patients require ongoing prosthetic care, physical therapy, and monitoring for complications such as skin breakdown or prosthetic malfunction.
Documentation Requirements
- ✓Confirmation of artificial left leg prosthetic presence
- ✓Level of amputation (above knee, below knee, etc.)
- ✓Type of prosthetic device
- ✓Functional status with prosthetic
- ✓Fit and comfort issues
- ✓Maintenance and adjustment needs
- ✓Physical therapy requirements
- ✓Integration with mobility aids