2027 ICD-10-CM Diagnosis Code Z89.412Acquired absence of left great toe

ICD-10-CM Codes›Z00–Z99›Z77-Z99›Z89

ICD-10-CM Z89.412
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

Z89.412 is a billable ICD-10-CM diagnosis code for acquired absence of left great toe. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 951. The code is not accepted as a principal diagnosis by the Medicare Code Editor and exempt from POA reporting. Coders also document this condition as history of amputation of hallux. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acquired absence of limb or organ.

Z89.412 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
Z89.412
Billable Status
Yes — Valid for Submission
Code Describes
Acquired absence of left great toe
Short Description
Acquired absence of left great toe
Same as the full description in the CMS dataset.
Parent Code
Z89.41
Acquired absence of great toe

Code Classification

ChapterZ00–Z99Factors influencing health status and contact with health services
SectionZ77-Z99Persons with potential health hazards related to family and personal history and certain conditions influencing health status
CategoryZ89Acquired absence of limb
This CodeZ89.412Acquired absence of left great toe

Code EditsBilling

Medicare Code Editor checks that affect claim validity for Z89.412.

Unacceptable principal diagnosis
There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Present on Admission (POA)Billing

Z89.412 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).

Medicare Risk Adjustment (HCC)Billing

Z89.412 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
Z89.412 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.

  • History of amputation of hallux
  • History of amputation of left great toe
  • History of amputation of right great toe
  • History of bilateral great toe amputation

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to Z89.412: its own notes plus those printed at Z89, block Z77-Z99, and Chapter 21. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Z89 Acquired absence of limb applies to 49 codes
  • amputation status
  • postprocedural loss of limb
  • post-traumatic loss of limb

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Z89 Acquired absence of limb applies to 49 codes
  • acquired deformities of limbs (M20-M21)
  • congenital absence of limbs (Q71-Q73)

Code Also

A second code may be needed to fully describe the condition; the note gives no sequencing direction.

From Block Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status applies to 567 codes
  • any follow-up examination (Z08-Z09)

Notes

General instructions on how these codes are used.

From Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
  • 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 Z89.412, its category, or a range that includes it.

Excludes1 2

These codes carry an Excludes1 note naming Z89.412: they are not reported together with it, unless the two conditions are unrelated.

  • M20 Acquired deformities of fingers and toes
    acquired absence of fingers and toes (Z89.-) names Z89.-, which includes this code
  • M21 Other acquired deformities of limbs
    acquired absence of limb (Z89.-) names Z89.-, which includes this code

Excludes2 2

These codes carry an Excludes2 note naming Z89.412: its condition is not part of those codes, and both may be reported when the patient has both.

  • Z89.42 Acquired absence of other toe(s)
    acquired absence of great toe (Z89.41-) names Z89.41-, which includes this code
  • M95 Other acquired deformities of musculoskeletal system and connective tissue
    acquired absence of limbs and organs (Z89-Z90) names Z89-Z90, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and Z89.412 is one of the codes named.

  • Z47.81 Encounter for orthopedic aftercare following surgical amputation
    code to identify the limb amputated (Z89.-) names Z89.-, which includes this code

Clinical ClassificationClinical

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

CCSR FAC022
Acquired absence of limb or organ
Default principal diagnosis: inpatient No · outpatient Yes

Clinical InformationClinical

  • Acquired Absence of Limb

    the absence of an extremity which is not present at birth and is the result of an injury or disease.

Patient EducationClinical

Toe Injuries and Disorders

Fourteen of the 26 bones in your feet are in your toes. The toes, particularly your big toe, help you move and keep your balance. Playing sports, running, stubbing your toe, and dropping something on your foot can damage your toes. Wearing shoes that are too loose or too tight can also cause toe problems.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert Z89.412 to ICD-9-CMHistory

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

ICD-9-CM
V49.71 Status amput great toe
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 Z89.412Overview

What is the ICD-10 code for acquired absence of left great toe?

The ICD-10-CM code for acquired absence of left great toe is Z89.412 (sometimes written as Z89412). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is Z89.412 (Acquired absence of great toe) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acquired absence of left great toe on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does Z89.412 group to?

On inpatient claims, acquired absence of left great toe maps to MS-DRG 951 (other Factors Influencing Health Status), which carries a relative weight of 0.5574. Higher weights mean higher Medicare reimbursement.

Can Z89.412 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because acquired absence of left great toe describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Is Z89.412 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 acquired absence of left great toe on inpatient claims. The code appears in the Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99) range of the CMS exempt list.

Does Z89.412 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage. Z89.412 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).