Skip to content
HCC Buddy home

M00.022 ICD-10-CM Code: Staphylococcal arthritis, left elbow

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Infectious arthropathies (M00-M02)

M00.022

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Staphylococcal arthritis, left elbow

A bacterial infection of the left elbow joint caused by Staphylococcus bacteria, resulting in inflammation and pain.

Buddy the Bee presenting code insight

Buddy Insight

Staphylococcal arthritis of the left elbow is a serious bacterial joint infection (septic arthritis) requiring emergency treatment to prevent permanent joint damage.

CMS-HCC V28

HCC 92

RAF 0.479

CMS-HCC V24

HCC 39

RAF 0.401

ACA/HHS

HCC 55

Varies by metal level

ESRD/PACE

HCC 39

RAF 0.092

RXHCC

N/A

—

Not mapped

Code Book Path

Official
M00.0Staphylococcal arthritis and polyarthritis
M00.02Staphylococcal arthritis, elbow
M00.022Staphylococcal arthritis, left elbow

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M00.022 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M00.022 in this effective period.

Related Child Codes

Official
M00.021Staphylococcal arthritis, right elbow
M00.029Staphylococcal arthritis, unspecified elbow

Includes

Official

ICD-10-CM does not list Includes notes for M00.022 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M00.022 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M00.022 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M00.022 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M00.022 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation identifying Staphylococcus as the causative organism (culture results, clinical diagnosis, or documented species)
Documentation of the affected joint with specific anatomical site
Laterality documented as left side
Clinical findings supporting joint infection (joint effusion, warmth, erythema, limited range of motion, fever)

MEAT Support

HCC Buddy guidance
Provider documentation identifying Staphylococcus as the causative organism (culture results, clinical diagnosis, or documented species)
Documentation of the affected joint with specific anatomical site
Laterality documented as left side
Clinical findings supporting joint infection (joint effusion, warmth, erythema, limited range of motion, fever)

Audit Caution

HCC Buddy guidance
Coding staphylococcal arthritis without confirmed Staphylococcus identification — if organism is unknown, use M00.9 (pyogenic arthritis, unspecified) instead
Failing to differentiate between Staphylococcus aureus and other Staphylococcus species when documentation is available — M00.0x covers all Staphylococcus species
Not coding associated conditions such as sepsis (A41.0x for Staphylococcal sepsis) or osteomyelitis when documented alongside the septic arthritis
Coding a single joint code when multiple joints are infected — use M00.09 (polyarthritis) when more than one joint is involved

Common Mistakes

HCC Buddy guidance
M00.12x — Pneumococcal arthritis of same joint site; differs by causative organism (Pneumococcus vs. Staphylococcus)
M00.22x — Streptococcal arthritis of same joint site; differs by causative organism (Streptococcus vs. Staphylococcus)
M00.82x — Arthritis due to other bacteria at same joint site; use when organism is identified but not Staphylococcus
M00.9 — Pyogenic arthritis, unspecified; use only when causative organism cannot be identified

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 M00.022 an HCC code?

Yes. M00.022 (Staphylococcal arthritis, left elbow) 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: M00.022 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
M00.022
Description
Staphylococcal arthritis, left elbow
HCC (V28)
HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
RAF
0.479
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
0.479
V24HCC 39, Bone/Joint/Muscle Infections/Necrosis
0.401
ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis
0.092

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 M00.022 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for M00.022

For M00.022 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 M00.022 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

M00.022 is the ICD-10-CM diagnosis code for staphylococcal arthritis, left elbow. A bacterial infection of the left elbow joint caused by Staphylococcus bacteria, resulting in inflammation and pain. M00.022 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering infectious arthropathies (m00-m02).

Under the CMS-HCC V28 risk adjustment model, M00.022 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, M00.022 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.

Verify the causative organism is confirmed as Staphylococcus before coding M00.0 series. Because M00.022 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 M00.022 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Verify the causative organism is confirmed as Staphylococcus before coding M00.0 series
  • •Ensure laterality (left elbow) is documented in the medical record to support the '2' fifth character

Clinical Significance

Staphylococcal arthritis of the left elbow is a serious bacterial joint infection (septic arthritis) requiring emergency treatment to prevent permanent joint damage. Staphylococcus is the most common causative organism in septic arthritis, and infection of the elbow joint carries risks of cartilage destruction, osteomyelitis, and systemic sepsis. Accurate site-specific coding is essential for risk adjustment and reflects the high acuity and resource needs of this condition.

Documentation Requirements

  • ✓Provider documentation identifying Staphylococcus as the causative organism (culture results, clinical diagnosis, or documented species)
  • ✓Documentation of the affected joint with specific anatomical site
  • ✓Laterality documented as left side
  • ✓Clinical findings supporting joint infection (joint effusion, warmth, erythema, limited range of motion, fever)
  • ✓Synovial fluid analysis results or culture and sensitivity reports when available
  • ✓Treatment documentation (antibiotics, joint aspiration, surgical drainage/washout)
  • ✓Assessment of whether the infection is acute or chronic, and whether it is a primary infection or secondary to another source

Commonly Confused Codes

  • •M00.12x: Pneumococcal arthritis of same joint site; differs by causative organism (Pneumococcus vs. Staphylococcus)
  • •M00.22x: Streptococcal arthritis of same joint site; differs by causative organism (Streptococcus vs. Staphylococcus)
  • •M00.82x: Arthritis due to other bacteria at same joint site; use when organism is identified but not Staphylococcus
  • •M00.9: Pyogenic arthritis, unspecified; use only when causative organism cannot be identified

Child Codes

M00.021Staphylococcal arthritis, right elbow
HCC 92
M00.022Staphylococcal arthritis, left elbow
HCC 92
M00.029Staphylococcal arthritis, unspecified elbow
HCC 92

Code Hierarchy

└M00Pyogenic arthritis└M00.0Staphylococcal arthritis and polyarthritis└M00.02Staphylococcal arthritis, elbow└M00.022Staphylococcal arthritis, left elbow
└M00.022Staphylococcal arthritis, left elbow

Because M00.022 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

M00.022 maps to CMS-HCC V28 category 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because M00.022 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work M00.022 in HCC Buddy

Open M00.022 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

Open in Code BookOpen in EncoderStart Pro