Is Z89.612 a billable ICD-10-CM code?

Yes. Z89.612 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does Z89.612 sit in the tabular list?

Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).

What cannot be coded together with Z89.612?

Z89.612 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z89.612 (Z89) and apply to it just the same.

Z89.612

Z89.612 — Acquired absence of left leg above knee

Billable / specific codeICD-10-CMPOA exemptleft

Z89.612 is a billable, specific ICD-10-CM code for acquired absence of left leg above knee. It is valid for submission on a claim.

Excludes1 inherited from the categories above Z89.612

These are not written on Z89.612, but they bind it: a note on a category applies to every code beneath it. Billing Z89.612 with anything listed here is a denial.

Written on Z89 — Acquired absence of limb

acquired deformities of limbs (M20-M21)
congenital absence of limbs (Q71-Q73)

Other codes that can never be billed with Z89.612

These codes carry an Excludes1 note pointing at Z89.612. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading Z89.612 alone.

M20Acquired deformities of fingers and toes
M21Other acquired deformities of limbs

Risk adjustment

Z89.612 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 409 Amputation Status, Lower Limb/Amputation Complications0.598 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

Z89.612 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53065Billing and Coding: Outpatient Physical Therapy
A57311Billing and Coding: Physical Therapy - Home Health

Code history

Z89.612 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share Z89.61. If Z89.612 is not quite right, the correct code is usually one of these.

Questions about Z89.612

Is Z89.612 a billable ICD-10-CM code?: Yes. Z89.612 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does Z89.612 sit in the tabular list?: Factors influencing health status and contact with health services (Z00-Z99), in the block Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99).
What cannot be coded together with Z89.612?: Z89.612 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above Z89.612 (Z89) and apply to it just the same.