Z99.2 ICD-10-CM Code: Dependence on renal dialysis
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)
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
00
RAF 0
CMS-HCC V24
MappedHCC 134
RAF 0.452
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 134
RAF 0.0
RXHCC
MappedHCC 261
RAF 0.0
Code Trumping
Basket needed
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 Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for Z99.2 in this effective period.
Excludes 1
Official- encounter for fitting and adjustment of dialysis catheter (Z49.0-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for Z99.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for Z99.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for Z99.2 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 Z99.2 an HCC code?
Yes. Z99.2 maps to Dialysis Status under the V24 model but is not retained in V28.
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 Z99.2
For Z99.2to 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 Z99.2 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
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).
Under the older CMS-HCC V24 model, Z99.2 maps to Dialysis Status (HCC 134) with a community, non-dual, aged base RAF weight of 0.452. 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.
Use this code for patients on any type of dialysis (hemodialysis, peritoneal dialysis, or continuous renal replacement therapy). Because Z99.2 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 Z99.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for patients on any type of dialysis (hemodialysis, peritoneal dialysis, or continuous renal replacement therapy)
- •This is a status code that should be reported for every encounter where the patient is dialysis-dependent; pair with the underlying kidney disease code (N18.x series)
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-)