M00.879
BillableArthritis due to other bacteria, unspecified ankle and foot
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M00.879 an HCC code?
Yes. M00.879 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 M00.879
For M00.879to 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 M00.879 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M00.879 is the ICD-10-CM diagnosis code for arthritis due to other bacteria, unspecified ankle and foot. Bacterial infection causing inflammation and swelling in the ankle and foot joints when the specific side (left or right) is not specified or documented. M00.879 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, M00.879 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, M00.879 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.
Use this code only when laterality cannot be determined from documentation. Because M00.879 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 M00.879 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Bacterial arthritis of unspecified ankle and foot indicates a serious infection of joints critical for ambulation, though documentation lacks laterality specification. This condition requires urgent treatment to prevent permanent mobility impairment and chronic disability.
Documentation Requirements
- ✓Evidence of 'other bacteria' causing ankle/foot infection
- ✓Documentation of ankle and foot joint involvement without laterality
- ✓Bacterial culture or microbiological evidence
- ✓Signs and symptoms of infectious arthritis
- ✓Treatment with systemic antibiotics
- ✓Assessment of weight-bearing and ambulation capacity
- ✓Laboratory markers of infection and inflammation
- ✓Clarification of laterality for future encounters
Commonly Confused Codes
- •M00.871/M00.872 — Same condition with specific laterality
- •M00079 — Streptococcal arthritis of unspecified ankle/foot (different organism)
- •M00019 — Staphylococcal arthritis of unspecified ankle/foot (specific bacteria)
- •M06.879 — Other rheumatoid arthritis of unspecified ankle/foot (autoimmune)
- •L03.119 — Cellulitis of unspecified foot (soft tissue)