ICD-10 Z48.290
Billable / Specific HCC v28: 186 CCEncounter for aftercare following bone marrow transplant
About ICD-10-CM Z48.290
ICD-10-CM code Z48.290 represents Encounter for aftercare following bone marrow transplant. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z48). The 2026 edition of ICD-10-CM Z48.290 became effective on October 1, 2025.
Coding Tips for Z48.290
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Z48.290 is a CMS-HCC v28 risk-adjustment code (category 186). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Z48.290 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Encounter for aftercare following bone marrow transplant. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for Z48.290
Local Coverage Determinations (LCDs) from CMS MACs that list Z48.290 as a covered diagnosis.
Showing top 10 of 216 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z48.290.
5 Medicare
CPT Codes Commonly Billed with Z48.290
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert Z48.290 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| Z48.290 | V4281 | 10112 |
| Z48.290 | V5844 | 10111 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z48.290
Other codes in section Z40-Z53 (Encounters for other specific health care).
ICD-10 Z48.290, Billing FAQ
Is ICD-10 code Z48.290 billable? +
Yes, Z48.290 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does Z48.290 affect Medicare Advantage HCC risk adjustment? +
Yes. Z48.290 maps to CMS-HCC v28 category 186. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is Z48.290 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does Z48.290 map to? +
Per CMS GEMs, Z48.290 maps to ICD-9 codes: V4281, V5844. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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