M02.131
BillablePostdysenteric arthropathy, right wrist
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M02.131 an HCC code?
Yes. M02.131 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 M02.131
For M02.131to 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 M02.131 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M02.131 is the ICD-10-CM diagnosis code for postdysenteric arthropathy, right wrist. Joint inflammation and pain in the right wrist that develops as a complication following a dysentery infection. M02.131 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, M02.131 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, M02.131 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.
Confirm right wrist is documented; left wrist requires code M02.132. Because M02.131 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 M02.131 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm right wrist is documented; left wrist requires code M02.132
- •Distinguish from other causes of wrist arthropathy by verifying dysentery history
Clinical Significance
Postdysenteric arthropathy of the right wrist represents a specific reactive arthritis following dysentery infection, affecting a joint crucial for hand function and daily activities. This condition requires ongoing management and monitoring due to its chronic inflammatory nature and potential impact on patient functional status.
Documentation Requirements
- ✓History of dysentery or severe infectious diarrheal illness
- ✓Right wrist joint involvement specifically documented
- ✓Evidence of arthropathy (joint inflammation, pain, stiffness)
- ✓Temporal relationship between infection and wrist symptoms
- ✓Chronic or persistent nature of joint condition
- ✓Physical examination findings supporting arthritis diagnosis
- ✓Exclusion of other wrist pathologies (trauma, degenerative changes)
Commonly Confused Codes
- •M02.132 — Postdysenteric arthropathy, left wrist (opposite laterality)
- •M02.139 — Postdysenteric arthropathy, unspecified wrist (when side not documented)
- •M00.031 — Staphylococcal arthritis, right wrist (direct infection, not reactive)
- •M06.831 — Other specified rheumatoid arthritis, right wrist (autoimmune etiology)
- •S63.001A — Unspecified dislocation of right wrist (acute injury, not arthropathy)