ICD-10 Z89.411
Billable / Specific HCC v28: 189Acquired absence of right great toe
About ICD-10-CM Z89.411
ICD-10-CM code Z89.411 represents Acquired absence of right great toe. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z89). The 2026 edition of ICD-10-CM Z89.411 became effective on October 1, 2025.
Coding Tips for Z89.411
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Z89.411 is a CMS-HCC v28 risk-adjustment code (category 189). 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.
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 Z89.411
Local Coverage Determinations (LCDs) from CMS MACs that list Z89.411 as a covered diagnosis.
Showing top 10 of 187 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing Z89.411.
3 Medicare
2 Aetna
CPT Codes Commonly Billed with Z89.411
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 Z89.411 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 |
|---|---|---|
| Z89.411 | V4971 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z89.411
Other codes in section Z77-Z99 (Persons with potential health hazards related to family and personal history and certain conditions influencing health status).
ICD-10 Z89.411, Billing FAQ
Is ICD-10 code Z89.411 billable? +
Yes, Z89.411 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does Z89.411 affect Medicare Advantage HCC risk adjustment? +
Yes. Z89.411 maps to CMS-HCC v28 category 189. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does Z89.411 map to? +
Per CMS GEMs, Z89.411 maps to ICD-9 codes: V4971. 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 May 31, 2026.
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