M00.831 ICD-10-CM Code: Arthritis due to other bacteria, right wrist
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Infectious arthropathies (M00-M02)
M00.831
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceArthritis due to other bacteria, right wrist
Infection and inflammation of the right wrist joint caused by bacteria other than the common ones typically associated with arthritis.
Buddy Insight
Bacterial arthritis of the right wrist represents a complex infection involving multiple small joints that can severely impact hand function and daily activities.
CMS-HCC V28
MappedHCC 92
RAF 0.209
CMS-HCC V24
MappedHCC 39
RAF 0.482
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 39
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Arthritis due to other bacteria, carpal bones
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M00.831 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M00.831 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M00.831 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M00.831 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M00.831 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M00.831 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is M00.831 an HCC code?
Yes. M00.831 maps to Bone/Joint/Muscle Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for M00.831
For M00.831to 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 M00.831 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
M00.831 is the ICD-10-CM diagnosis code for arthritis due to other bacteria, right wrist. Infection and inflammation of the right wrist joint caused by bacteria other than the common ones typically associated with arthritis. M00.831 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, M00.831 maps to Bone/Joint/Muscle Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.209. Under the older V24 model, M00.831 mapped to the same category but with a base RAF weight of 0.482, V28 recalibrated weights across the entire model. 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.
Ensure documentation specifies the right wrist as the affected site. Because M00.831 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 M00.831 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies the right wrist as the affected site
- •Distinguish between wrist arthritis and carpal tunnel or other wrist conditions
Clinical Significance
Bacterial arthritis of the right wrist represents a complex infection involving multiple small joints that can severely impact hand function and daily activities. The intricate anatomy of the wrist makes treatment challenging and functional recovery more difficult.
Documentation Requirements
- ✓Identification of causative bacteria as 'other bacteria' type
- ✓Specific documentation of right wrist joint involvement
- ✓Microbiological evidence supporting bacterial infection
- ✓Clinical findings consistent with infectious arthritis
- ✓Documentation of antibiotic treatment regimen
- ✓Assessment of wrist function and range of motion
- ✓Laboratory evidence of infection (cultures, inflammatory markers)
- ✓Exclusion of crystal arthropathy and autoimmune conditions
Commonly Confused Codes
- •M00031: Streptococcal arthritis of right wrist (different organism)
- •M00013: Staphylococcal arthritis of right wrist (specific bacteria)
- •M06.831: Other rheumatoid arthritis of right wrist (autoimmune disease)
- •M19.031: Primary osteoarthritis of right wrist (degenerative)
- •M70.031: Crepitant synovitis of right wrist (mechanical inflammation)