2027 ICD-10-CM Diagnosis Code Z89.619Acquired absence of unspecified leg above knee
Z89.619 is a billable ICD-10-CM diagnosis code for acquired absence of unspecified leg above knee. 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 above knee. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Acquired absence of limb or organ.
For Medicare Advantage risk adjustment, Z89.619 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 Z89.619.
Present on Admission (POA)Billing
Z89.619 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
Z89.619 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 above knee
- Amputated at lower thigh
- Amputated at mid thigh
- Amputated at upper thigh
- Amputated lower limb
- Amputee gait
- History of amputation of leg through tibia and fibula
- History of amputation of lower limb above knee
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z89.619: 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 Z89.619, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming Z89.619: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 1
These codes carry an Excludes2 note naming Z89.619: 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 Z89.619 is one of the codes named.
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.
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 Z89.619 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z89.619Overview
What is the ICD-10 code for acquired absence of unspecified leg above knee?
The ICD-10-CM code for acquired absence of unspecified leg above knee is Z89.619 (sometimes written as Z89619). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z89.619 (Acquired absence of leg above knee) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report acquired absence of unspecified leg above knee on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z89.619 group to?
On inpatient claims, acquired absence of unspecified leg above knee 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 Z89.619 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because acquired absence of unspecified leg above knee describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Is Z89.619 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 unspecified leg above knee 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 Z89.619?
Z89.619 (acquired absence of unspecified leg above knee) 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 Z89.619 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, Z89.619 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.
