Z99.2 ICD-10-CM Code: Dependence on renal dialysis
Z99.2 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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)
Z99.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDependence on renal dialysis
A patient requires regular kidney dialysis treatment to filter waste products from their blood because their kidneys no longer function adequately. This code indicates the patient's dependence on this life-sustaining treatment.
Buddy Insight
This code represents complete dependence on regular dialysis for survival due to end-stage renal disease, indicating extremely high mortality risk without treatment and complex ongoing medical management needs.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 134
Code-level coefficient reference
RXHCC
MappedHCC 261
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Hemodialysis status
- Peritoneal dialysis status
- Presence of arteriovenous shunt for dialysis
- Renal dialysis status NOS
Excludes 2
Official- noncompliance with renal dialysis (Z91.15-)
Related Codes
Includes
OfficialNo Includes notes are included in this display for Z99.2. Check the code and parent instructions in the Code Book.
Excludes 1
Official- encounter for fitting and adjustment of dialysis catheter (Z49.0-)
Code First
OfficialNo Code First sequencing instructions are included in this display for Z99.2. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for Z99.2. Check the code and parent instructions in the Code Book.
Code Also
Official- any follow-up examination (Z08-Z09)Inherited from Z77-Z99
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is Z99.2 an HCC code?
Z99.2 is not in the CMS-HCC V28 or V24 community payment model. Z99.2 has a separate mapping under the CMS-HCC ESRD model (HCC 134 (Dialysis Status)) and the Part D RxHCC model (HCC 261 (Dialysis Status, Including End Stage Renal Disease)); the applicable result needs member context.
- Code
- Z99.2
- Description
- Dependence on renal dialysis
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work Z99.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for Z99.2
For Z99.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
Z99.2 is the ICD-10-CM diagnosis code for dependence on renal dialysis. A patient requires regular kidney dialysis treatment to filter waste products from their blood because their kidneys no longer function adequately. This code indicates the patient's dependence on this life-sustaining treatment. Z99.2 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).
Z99.2 has no mapping under the CMS-HCC V28 or V24 community payment models. Z99.2 has a separate mapping under the CMS-HCC ESRD model (HCC 134 (Dialysis Status)) and the Part D RxHCC model (HCC 261 (Dialysis Status, Including End Stage Renal Disease)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Z99.2 is the 'dependence on renal dialysis' status code. Pair with N18.6 for ESRD; per ICD-10-CM convention, both should appear on the claim when the patient is dialysis-dependent.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for Z99.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Z99.2 is the 'dependence on renal dialysis' status code. Pair with N18.6 for ESRD; per ICD-10-CM convention, both should appear on the claim when the patient is dialysis-dependent.
- •Z99.2 is not reportable on its own as a primary diagnosis for a dialysis encounter, the underlying ESRD (N18.6) drives the principal diagnosis. Coders sometimes sequence these incorrectly.
- •Z99.2 does not map to a standard CMS-HCC V28 category; CMS prices dialysis-dependent members through its separate ESRD payment model rather than a community HCC. Presence of Z99.2 on the claim is a strong signal to auditors that ESRD risk adjustment should apply.
Clinical Significance
This code represents complete dependence on regular dialysis for survival due to end-stage renal disease, indicating extremely high mortality risk without treatment and complex ongoing medical management needs. These patients require lifelong dialysis access care, fluid management, and monitoring for dialysis-related complications.
Documentation Requirements
- ✓Confirmation of dialysis dependence
- ✓Type of dialysis (hemodialysis vs peritoneal)
- ✓Dialysis schedule and frequency
- ✓Vascular or peritoneal access status
- ✓Dialysis adequacy parameters
- ✓Fluid restriction requirements
- ✓Underlying kidney disease etiology
- ✓Transplant candidacy status
Excludes 1, Do NOT code together
- encounter for fitting and adjustment of dialysis catheter (Z49.0-)
Excludes 2, Not included here, may code separately
- noncompliance with renal dialysis (Z91.15-)