B42.82 ICD-10-CM Code: Sporotrichosis arthritis
B42.82 maps to CMS-HCC V28 92 (RAF 0.479). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Mycoses (B35-B49)
B42.82
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSporotrichosis arthritis
A fungal infection of the joints caused by Sporothrix that causes inflammation and joint damage.
Buddy Insight
Sporotrichosis arthritis is a rare fungal joint infection caused by Sporothrix schenckii that causes destructive arthritis requiring prolonged antifungal therapy and potentially surgical intervention.
CMS-HCC V28
MappedHCC 92
RAF 0.479
CMS-HCC V24
MappedHCC 39
RAF 0.401
ACA/HHS
MappedHCC 55
Varies by metal level
ESRD/PACE
MappedHCC 39
RAF 0.092
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for B42.82 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for B42.82 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for B42.82 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for B42.82 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for B42.82 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for B42.82 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for B42.82 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is B42.82 an HCC code?
Yes. B42.82 (Sporotrichosis arthritis) maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24), with a community non-dual aged RAF of 0.479. It is billable for payment year 2026.
Coder answer: B42.82 is billable and maps to V28 HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- B42.82
- Description
- Sporotrichosis arthritis
- HCC (V28)
- HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- RAF
- 0.479
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work B42.82 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for B42.82
For B42.82 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed B42.82 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
B42.82 is the ICD-10-CM diagnosis code for sporotrichosis arthritis. A fungal infection of the joints caused by Sporothrix that causes inflammation and joint damage. B42.82 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering mycoses (b35-b49).
Under the CMS-HCC V28 risk adjustment model, B42.82 maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.479. Under the older CMS-HCC V24 model, B42.82 maps to Bone/Joint/Muscle Infections/Necrosis (HCC 39) with a community, non-dual, aged base RAF weight of 0.401. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Document which joints are affected and whether this is monoarticular or polyarticular involvement. Because B42.82 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B42.82 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document which joints are affected and whether this is monoarticular or polyarticular involvement
- •Distinguish from other causes of arthritis; sporotrichosis arthritis is relatively rare
Clinical Significance
Sporotrichosis arthritis is a rare fungal joint infection caused by Sporothrix schenckii that causes destructive arthritis requiring prolonged antifungal therapy and potentially surgical intervention. It maps to a musculoskeletal infection HCC rather than a general opportunistic infection HCC, reflecting its distinct clinical impact on bone and joint structures.
Documentation Requirements
- ✓Culture-confirmed Sporothrix schenckii from joint aspirate or synovial tissue
- ✓Specific joint(s) affected documented with laterality
- ✓Imaging findings showing joint destruction, erosions, or synovial thickening
- ✓Occupational or environmental exposure history (gardeners, rose thorn injuries, sphagnum moss)
- ✓Duration of arthritis and treatment plan (itraconazole long-term, amphotericin B for severe cases)
Commonly Confused Codes
- •B42.0 (Pulmonary sporotrichosis) - lung involvement is coded separately from joint involvement
- •B42.7 (Disseminated sporotrichosis) - use when multiple organ systems are involved, not just joints
- •M00.9 (Pyogenic arthritis, unspecified) - bacterial joint infection; sporotrichosis is fungal and requires specific coding