2027 ICD-10-CM Diagnosis Code S78.011AComplete traumatic amputation at right hip joint, initial encounter
ICD-10-CM Codes›S00–T88›S70-S79›S78
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 405
- 7th Character A — Initial Encounter
- Chronic Condition
S78.011A is a billable ICD-10-CM diagnosis code for complete traumatic amputation at right hip joint, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 913 through 914, 963 through 965. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 229 closely related codes. Coders also document this condition as amputated at hip. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Amputation of a limb, initial encounter.
For Medicare Advantage risk adjustment, S78.011A maps to CMS-HCC Category 405 (Traumatic Amputations and Complications) under the V28 model, adding a risk factor of about 0.598 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
S78.011A maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Amputated at hip
- Bilateral traumatic amputation of legs through hip joints
- Bilateral traumatic amputation of lower limbs
- Traumatic amputation at left hip joint
- Traumatic amputation at right hip joint
- Traumatic amputation, through hip
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Traumatic amputation of hip and thigh (S78). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to S78.011A: its own notes plus those printed at S78, block S70-S79, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Notes
General instructions on how these codes are used.
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from category S78
- Ainitial encounter this code
- Dsubsequent encounter
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S78.011A, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming S78.011A: they are not reported together with it, unless the two conditions are unrelated.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Limb Loss
People can lose all or part of an arm or leg for many reasons. Common ones include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert S78.011A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S78.011AOverview
What is the ICD-10 code for complete traumatic amputation at right hip joint, initial encounter?
The ICD-10-CM code for complete traumatic amputation at right hip joint, initial encounter is S78.011A (sometimes written as S78011A). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is S78.011A (Complete traumatic amputation at right hip joint) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report complete traumatic amputation at right hip joint, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character A in S78.011A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for complete traumatic amputation at right hip joint, such as an emergency visit or first evaluation.
What MS-DRG does S78.011A group to?
When complete traumatic amputation at right hip joint, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 914, 913, 963, with relative weights from 0.9281 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S78.011A a CC or MCC?
CMS lists S78.011A as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 229 closely related codes in its exclusion list.
What HCC is S78.011A?
S78.011A (complete traumatic amputation at right hip joint, initial encounter) maps to CMS-HCC Category 405 (Traumatic Amputations and Complications), commonly written as HCC 405, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 173 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does S78.011A risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, S78.011A adds a risk adjustment factor of about 0.598 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.284 to 0.844 depending on the payment segment). HCC 405 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 405 category page.
