M01.X42 ICD-10-CM Code: Direct infection of left hand in infectious and parasitic diseases classified elsewhere

Code

M01.X42

Description

Direct infection of left hand in infectious and parasitic diseases classified elsewhere

HCC (V28)

HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis

RAF reference coefficient

0.479

Billable

Yes

Payment year

2026

HCC Category Mapping

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work M01.X42 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for M01.X42

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for M01.X42 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Document the specific underlying infectious disease to assign the appropriate secondary code
• •This represents a secondary joint infection manifestation of another primary infectious condition

Clinical Significance

Direct infection of the left hand joints resulting from infectious or parasitic diseases classified elsewhere represents a serious condition with significant functional implications. The hand's complex anatomy and critical role in daily activities make this diagnosis particularly important for maintaining quality of life and independence.

Documentation Requirements

• ✓Specific documentation of left hand joint infection
• ✓Primary diagnosis of underlying infectious or parasitic disease (A00-B99)
• ✓Clear evidence that hand infection is direct result of classified disease
• ✓Clinical assessment documenting hand joint inflammation and functional limitation
• ✓Laboratory evidence supporting infectious process and systemic inflammation
• ✓Radiographic studies confirming hand joint involvement
• ✓Joint aspiration results including culture and sensitivity when performed
• ✓Comprehensive treatment plan for both systemic and local hand infection

Commonly Confused Codes

• •M00.942: Pyogenic arthritis, left hand (routine bacterial joint infection)
• •M25.542: Pain in left hand (joint symptoms without infectious cause)
• •M01.X41: Direct infection of right hand in infectious diseases classified elsewhere
• •M02.142: Postdysenteric arthropathy, left hand (reactive arthropathy following dysentery)

Child Codes