2027 ICD-10-CM Diagnosis Code S78.111DComplete traumatic amputation at level between right hip and knee, subsequent encounter

ICD-10-CM Codes›S00–T88›S70-S79›S78

ICD-10-CM S78.111D
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

S78.111D is a billable ICD-10-CM diagnosis code for complete traumatic amputation at level between right hip and knee, subsequent encounter. The 7th character D marks it as a subsequent encounter code, used during routine care in the healing or recovery phase. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 949 through 950. The code is exempt from POA reporting. Coders also document this condition as traumatic amputation of right lower limb through thigh. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Amputation of a limb, subsequent encounter.

S78.111D no longer risk-adjusts for Medicare Advantage: it mapped to HCC 189 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 189, ESRD (V21) category 189, and ESRD (V24) category 189 for payment year 2027.

Code Identity

ICD-10-CM Code
S78.111D
Billable Status
Yes — Valid for Submission
Code Describes
Complete traumatic amputation at level between right hip and knee, subsequent encounter
Short Description
Complete traumatic amp at level betw r hip and knee, subs
Parent Code
S78.111
Complete traumatic amputation at level between right hip and knee

Code Classification

ChapterS00–T88Injury, poisoning and certain other consequences of external causes
SectionS70-S79Injuries to the hip and thigh
CategoryS78Traumatic amputation of hip and thigh
This CodeS78.111DComplete traumatic amputation at level between right hip and knee, subsequent encounter

Present on Admission (POA)Billing

S78.111D is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Injuries to the hip and thigh (S70-S79).

Medicare Risk Adjustment (HCC)Billing

S78.111D no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
Dropped in V28 see all codes that no longer risk-adjust
Prior Model (CMS-HCC V24)
HCC 189
V24 retired last contributed to a Medicare Advantage risk score in payment year 2025
Other CMS Models
PACE (CMS-HCC V22): HCC 189 · ESRD (V21): HCC 189 · ESRD (V24): HCC 189
ESRD V21 weights: 0.090 dialysis, 0.339–0.654 functioning graft · ESRD V24 weights: 0.081 dialysis, 0.396–0.831 functioning graft
Part D (RxHCC)
Not mapped
S78.111D does not risk-adjust in the RxHCC prescription drug model

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.

  • Traumatic amputation of right lower limb through thigh
  • Traumatic amputation, through thigh

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 S78.111D: its own notes plus those printed at S78.1, 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.

From S78.1 Traumatic amputation at level between hip and knee applies to 18 codes
  • traumatic amputation of knee (S88.0-)
From S78 Traumatic amputation of hip and thigh applies to 54 codes
  • traumatic amputation of knee (S88.0-)

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.

From Block S70-S79 Injuries to the hip and thigh applies to 3,546 codes
From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • code to identify any retained foreign body, if applicable (Z18.-)

Notes

General instructions on how these codes are used.

From Chapter 19 (S00-T88) Injury, poisoning and certain other consequences of external causes applies to 41,187 codes
  • 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.

From S78 Traumatic amputation of hip and thigh applies to 54 codes
  • The appropriate 7th character is to be added to each code from category S78
Values for category S78 Encounter: Initial, Subsequent, Sequela
  • Ainitial encounter
  • Dsubsequent encounter this code
  • 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 S78.111D, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming S78.111D: they are not reported together with it, unless the two conditions are unrelated.

  • S71 Open wound of hip and thigh
    traumatic amputation of hip and thigh (S78.-) names S78.-, which includes this code
  • S72 Fracture of femur
    traumatic amputation of hip and thigh (S78.-) names S78.-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INJ051
Amputation of a limb, subsequent encounter
Default principal diagnosis: inpatient Yes · outpatient Yes

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 S78.111D to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
V58.89 Other specfied aftercare
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About S78.111DOverview

Is S78.111D a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report complete traumatic amputation at level between right hip and knee, subsequent encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What does the 7th character D in S78.111D mean?

The final character D marks a subsequent encounter: use it for routine care while the complete traumatic amputation at level between right hip and knee is healing, after active treatment has ended.

What MS-DRG does S78.111D group to?

When complete traumatic amputation at level between right hip and knee, subsequent encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 950, 949, with relative weights from 0.7661 to 1.1231 depending on complications. Higher weights mean higher Medicare reimbursement.

Is S78.111D exempt from POA reporting?

Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for complete traumatic amputation at level between right hip and knee, subsequent encounter on inpatient claims. The code appears in the Injuries to the hip and thigh (S70-S79) range of the CMS exempt list.

Can S78.111D be reported with a code from S88.0?

Not as a rule. The Excludes1 note at S78.1, which applies to S78.111D, lists "traumatic amputation of knee (S88.0-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does S78.111D risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. S78.111D mapped to HCC 189 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 189 (Amputation Status/Lower Limb/Amputation Complications), ESRD (V21) category 189 (Amputation Status/Lower Limb/Amputation Complications), and ESRD (V24) category 189 (Amputation Status/Lower Limb/Amputation Complications).