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409 HCC

Amputation Status, Lower Limb/Amputation Complications

CMS Model V28 44 Associated ICD-10 Diagnoses

Relative Risk Score Factors (Coefficients for HCC 409)

Enrollment Model Type Coeff Tag Year Weight Score
CFA HCC409 2026 + 0.799
CFD HCC409 2026 + 0.844
CNA HCC409 2026 + 0.598
CND HCC409 2026 + 0.562
CPA HCC409 2026 + 0.604
CPD HCC409 2026 + 0.623
INS HCC409 2026 + 0.284

Mapped ICD-10-CM Diagnoses (44)

The following diagnoses map directly to HCC 409 under the V28 risk adjustment model:

ICD-10 Code Clinical Diagnosis Description Guideline
G54.6 Phantom limb syndrome with pain Notes ↗
G54.7 Phantom limb syndrome without pain Notes ↗
T87.30 Neuroma of amputation stump, unspecified extremity Notes ↗
T87.31 Neuroma of amputation stump, right upper extremity Notes ↗
T87.32 Neuroma of amputation stump, left upper extremity Notes ↗
T87.33 Neuroma of amputation stump, right lower extremity Notes ↗
T87.34 Neuroma of amputation stump, left lower extremity Notes ↗
T87.40 Infection of amputation stump, unspecified extremity Notes ↗
T87.41 Infection of amputation stump, right upper extremity Notes ↗
T87.42 Infection of amputation stump, left upper extremity Notes ↗
T87.43 Infection of amputation stump, right lower extremity Notes ↗
T87.44 Infection of amputation stump, left lower extremity Notes ↗
T87.50 Necrosis of amputation stump, unspecified extremity Notes ↗
T87.51 Necrosis of amputation stump, right upper extremity Notes ↗
T87.52 Necrosis of amputation stump, left upper extremity Notes ↗
T87.53 Necrosis of amputation stump, right lower extremity Notes ↗
T87.54 Necrosis of amputation stump, left lower extremity Notes ↗
T87.81 Dehiscence of amputation stump Notes ↗
T87.89 Other complications of amputation stump Notes ↗
T87.9 Unspecified complications of amputation stump Notes ↗
Z44.101 Encounter for fitting and adjustment of unspecified right artificial leg Notes ↗
Z44.102 Encounter for fitting and adjustment of unspecified left artificial leg Notes ↗
Z44.109 Encounter for fitting and adjustment of unspecified artificial leg, unspecified leg Notes ↗
Z44.111 Encounter for fitting and adjustment of complete right artificial leg Notes ↗
Z44.112 Encounter for fitting and adjustment of complete left artificial leg Notes ↗
Z44.119 Encounter for fitting and adjustment of complete artificial leg, unspecified leg Notes ↗
Z44.121 Encounter for fitting and adjustment of partial artificial right leg Notes ↗
Z44.122 Encounter for fitting and adjustment of partial artificial left leg Notes ↗
Z44.129 Encounter for fitting and adjustment of partial artificial leg, unspecified leg Notes ↗
Z89.431 Acquired absence of right foot Notes ↗
Z89.432 Acquired absence of left foot Notes ↗
Z89.439 Acquired absence of unspecified foot Notes ↗
Z89.441 Acquired absence of right ankle Notes ↗
Z89.442 Acquired absence of left ankle Notes ↗
Z89.449 Acquired absence of unspecified ankle Notes ↗
Z89.511 Acquired absence of right leg below knee Notes ↗
Z89.512 Acquired absence of left leg below knee Notes ↗
Z89.519 Acquired absence of unspecified leg below knee Notes ↗
Z89.611 Acquired absence of right leg above knee Notes ↗
Z89.612 Acquired absence of left leg above knee Notes ↗
Z89.619 Acquired absence of unspecified leg above knee Notes ↗
Z97.13 Presence of artificial right leg (complete) (partial) Notes ↗
Z97.14 Presence of artificial left leg (complete) (partial) Notes ↗
Z97.16 Presence of artificial legs, bilateral (complete) (partial) Notes ↗
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