2027 ICD-10-CM Diagnosis Code Z49.01Encounter for fitting and adjustment of extracorporeal dialysis catheter
Z49.01 is a billable ICD-10-CM diagnosis code for encounter for fitting and adjustment of extracorporeal dialysis catheter. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 698 through 700. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Chronic kidney disease and Other aftercare encounter.
Z49.01 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 134 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 134, ESRD (V21) category 134, ESRD (V24) category 134, and RxHCC Part D (V08) category 261 for payment year 2027.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z49.01.
Present on Admission (POA)Billing
Z49.01 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Encounters for other specific health care (Z40-Z53).
Medicare Risk Adjustment (HCC)Billing
Z49.01 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.
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.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z49.01: its own notes plus those printed at Z49, block Z40-Z53, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Removal or replacement of renal dialysis catheter
- Toilet or cleansing of renal dialysis catheter
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.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name Z49.01, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming Z49.01: they are not reported together with it, unless the two conditions are unrelated.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Dialysis
When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z49.01 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z49.01Overview
Is Z49.01 (Preparatory care for renal dialysis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report encounter for fitting and adjustment of extracorporeal dialysis catheter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z49.01 group to?
On inpatient claims, encounter for fitting and adjustment of extracorporeal dialysis catheter maps to MS-DRG 699, 698, 700, with relative weights from 0.6740 to 1.6400 depending on complications. Higher weights mean higher Medicare reimbursement.
Can Z49.01 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because encounter for fitting and adjustment of extracorporeal dialysis catheter describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z49.01 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 encounter for fitting and adjustment of extracorporeal dialysis catheter on inpatient claims. The code appears in the Encounters for other specific health care (Z40-Z53) range of the CMS exempt list.
What is the ICD-9 equivalent of Z49.01?
Under the General Equivalence Mappings, encounter for fitting and adjustment of extracorporeal dialysis catheter converts to ICD-9-CM V56.1 (ft/adj xtrcorp dial cath). The mapping is a direct match.
Does Z49.01 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. Z49.01 mapped to HCC 134 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 134 (Dialysis Status), ESRD (V21) category 134 (Dialysis Status), ESRD (V24) category 134 (Dialysis Status), and RxHCC Part D (V08) category 261 (Dialysis Status, Including End Stage Renal Disease).
