M00.041 ICD-10-CM Code: Staphylococcal arthritis, right hand
M00.041 maps to CMS-HCC V28 92 (RAF 0.479). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools
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)
M00.041
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceStaphylococcal arthritis, right hand
A bacterial infection of the right hand joint caused by Staphylococcus bacteria, causing inflammation and pain in the hand.
Buddy Insight
Staphylococcal arthritis of the right hand is a serious bacterial joint infection (septic arthritis) requiring emergency treatment to prevent permanent joint damage.
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
Official- Staphylococcal arthritis of metacarpus and phalanges
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M00.041 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M00.041 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M00.041 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M00.041 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M00.041 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M00.041 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 M00.041 an HCC code?
Yes. M00.041 (Staphylococcal arthritis, right hand) 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: M00.041 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
- M00.041
- Description
- Staphylococcal arthritis, right hand
- 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 M00.041 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for M00.041
For M00.041 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 M00.041 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
M00.041 is the ICD-10-CM diagnosis code for staphylococcal arthritis, right hand. A bacterial infection of the right hand joint caused by Staphylococcus bacteria, causing inflammation and pain in the hand. M00.041 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, M00.041 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, M00.041 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.
Clarify if infection involves multiple joints in the hand; may require additional codes. Because M00.041 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 M00.041 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Clarify if infection involves multiple joints in the hand; may require additional codes
- •Verify right hand is documented to support the '1' fifth character
Clinical Significance
Staphylococcal arthritis of the right hand 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 hand 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 right 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
- •M00.14x: Pneumococcal arthritis of same joint site; differs by causative organism (Pneumococcus vs. Staphylococcus)
- •M00.24x: Streptococcal arthritis of same joint site; differs by causative organism (Streptococcus vs. Staphylococcus)
- •M00.84x: 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