Z89.449 Acquired absence of unspecified ankle

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)

Applies from Z89.44 Acquired absence of ankle

Applicable to

• Disarticulation of ankle

Risk adjustment (HCC)

• CMS-HCC V28: HCC 409 — Amputation Status, Lower Limb/Amputation Complications
• 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)

• V49.74 Ankle 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 Z89.449

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

• Z89.432 Acquired absence of left foot
• Z89.439 Acquired absence of unspecified foot
• Z89.44 Acquired absence of ankle
• Z89.441 Acquired absence of right ankle
• Z89.442 Acquired absence of left ankle
• Z89.449 Acquired absence of unspecified ankle (this code)
• Z89.5 Acquired absence of leg below knee
• Z89.51 Acquired absence of leg below knee
• Z89.511 Acquired absence of right leg below knee
• Z89.512 Acquired absence of left leg below knee
• Z89.519 Acquired absence of unspecified leg below knee