ICD-10 Z89.419
Billable / Specific HCC v28: 189Acquired absence of unspecified great toe
About ICD-10-CM Z89.419
ICD-10-CM code Z89.419 represents Acquired absence of unspecified great toe. This is a billable/specific code in the Factors Influencing Health Status chapter (block Z89). The 2026 edition of ICD-10-CM Z89.419 became effective on October 1, 2025.
Coding Tips for Z89.419
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
Z89.419 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 Z89.419
Local Coverage Determinations (LCDs) from CMS MACs that list Z89.419 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 Z89.419.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but Z89.419 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with Z89.419
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 Z89.419 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 |
|---|---|---|
| Z89.419 | V4971 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To Z89.419
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 Z89.419, Billing FAQ
Is ICD-10 code Z89.419 billable? +
Yes, Z89.419 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does Z89.419 affect Medicare Advantage HCC risk adjustment? +
Yes. Z89.419 maps to CMS-HCC v28 category 189. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does Z89.419 map to? +
Per CMS GEMs, Z89.419 maps to ICD-9 codes: V4971. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team