ICD-10 Z49.01
Billable / Specific HCC v28: 134Encounter for fitting and adjustment of extracorporeal dialysis catheter
About ICD-10-CM Z49.01
ICD-10-CM code Z49.01 represents Encounter for fitting and adjustment of extracorporeal dialysis catheter. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z49). The 2026 edition of ICD-10-CM Z49.01 became effective on October 1, 2025.
Coding Tips for Z49.01
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Z49.01 is a CMS-HCC v28 risk-adjustment code (category 134). 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under Z49.01. Per CMS ICD-10-CM Tabular 2026.
- Removal or replacement of renal dialysis catheter
- Toilet or cleansing of renal dialysis catheter
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.
Medicare LCD Coverage for Z49.01
Local Coverage Determinations (LCDs) from CMS MACs that list Z49.01 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z49.01.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Z49.01 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Z49.01
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 Z49.01 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 |
|---|---|---|
| Z49.01 | V561 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z49.01
Other codes in section Z40-Z53 (Encounters for other specific health care).
ICD-10 Z49.01, Billing FAQ
Is ICD-10 code Z49.01 billable? +
Yes, Z49.01 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to Z49.01? +
ICD-10 Z49.01 includes: Removal or replacement of renal dialysis catheter; Toilet or cleansing of renal dialysis catheter.
Does Z49.01 affect Medicare Advantage HCC risk adjustment? +
Yes. Z49.01 maps to CMS-HCC v28 category 134. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does Z49.01 map to? +
Per CMS GEMs, Z49.01 maps to ICD-9 codes: V561. 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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