2027 ICD-10-CM Diagnosis Code Z89.432Acquired absence of left foot
Z89.432 is a billable ICD-10-CM diagnosis code for acquired absence of left foot. 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 amputated left forefoot. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acquired absence of limb or organ.
For Medicare Advantage risk adjustment, Z89.432 maps to CMS-HCC Category 409 (Amputation Status, Lower Limb/Amputation 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
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z89.432.
Present on Admission (POA)Billing
Z89.432 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
Z89.432 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 left forefoot
- History of amputation of left foot
- History of amputation of left forefoot
- History of amputation of left midfoot
- History of amputation of right foot
- History of bilateral foot amputation
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z89.432: 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.
- 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.
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 Z89.432, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming Z89.432: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 1
These codes carry an Excludes2 note naming Z89.432: its condition is not part of those codes, and both may be reported when the patient has both.
- M95 Other acquired deformities of musculoskeletal system and connective tissue
Use Additional Code 1
These codes say to use an additional code from the note, and Z89.432 is one of the codes named.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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
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 Z89.432 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z89.432Overview
What is the ICD-10 code for acquired absence of left foot?
The ICD-10-CM code for acquired absence of left foot is Z89.432 (sometimes written as Z89432). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z89.432 (Acquired absence of foot) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report acquired absence of left foot on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z89.432 group to?
On inpatient claims, acquired absence of left foot 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 Z89.432 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because acquired absence of left foot describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z89.432 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 foot 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.
What HCC is Z89.432?
Z89.432 (acquired absence of left foot) maps to CMS-HCC Category 409 (Amputation Status, Lower Limb/Amputation Complications), commonly written as HCC 409, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 189 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 Z89.432 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, Z89.432 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). A more severe related category (HCC 263 and HCC 405) supersedes it when both are reported. See the full factor table on the HCC 409 category page.
