Z89.411 Acquired absence of right great toe

Billable ICD-10-CM code, FY2026. Exempt from present-on-admission (POA) reporting.

Applies from Z89 Acquired absence of limb

Includes

• amputation status
• postprocedural loss of limb
• post-traumatic loss of limb

Excludes1 (never code together)

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

Risk adjustment (HCC)

• CMS-HCC V22: HCC 189 — Amputation Status, Lower Limb/Amputation Complications
• ESRD V24: HCC 189

MS-DRG index

Defines the logic of DRG(s) 951 in MDC 23.

Approximate ICD-9-CM (GEMs)

• V49.71 Great toe amputation status (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Unacceptable principal diagnosis: These codes describe a circumstance which influences care but is not a current illness or injury, or capture only an underlying condition, and are unacceptable as principal diagnosis.

Code annotations containing back-references to Z89.411

Back-references to Z89.41

• Type 2 Excludes: Z89.42 Acquired absence of other toe(s) ("acquired absence of great toe (Z89.41-)")

Back-references to Z89

• Type 1 Excludes: M20 Acquired deformities of fingers and toes ("acquired absence of fingers and toes (Z89.-)")
• Type 1 Excludes: M21 Other acquired deformities of limbs ("acquired absence of limb (Z89.-)")
• Type 2 Excludes: M95 Other acquired deformities of musculoskeletal system and connective tissue ("acquired absence of limbs and organs (Z89-Z90)")
• Use Additional: Z47.81 Encounter for orthopedic aftercare following surgical amputation ("code to identify the limb amputated (Z89.-)")

Nearby codes

• Z89.231 Acquired absence of right shoulder
• Z89.232 Acquired absence of left shoulder
• Z89.239 Acquired absence of unspecified shoulder
• Z89.4 Acquired absence of toe(s), foot, and ankle
• Z89.41 Acquired absence of great toe
• Z89.411 Acquired absence of right great toe (this code)
• Z89.412 Acquired absence of left great toe
• Z89.419 Acquired absence of unspecified great toe
• Z89.42 Acquired absence of other toe(s)
• Z89.421 Acquired absence of other right toe(s)
• Z89.422 Acquired absence of other left toe(s)