M02.151
BillablePostdysenteric arthropathy, right hip
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M02.151 an HCC code?
Yes. M02.151 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).
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 M02.151
For M02.151to 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 M02.151 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M02.151 is the ICD-10-CM diagnosis code for postdysenteric arthropathy, right hip. Joint inflammation and pain in the right hip that develops after a dysentery infection (severe diarrheal illness). M02.151 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, M02.151 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, M02.151 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.
Verify the right hip is specifically documented as the affected joint. Because M02.151 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 M02.151 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the right hip is specifically documented as the affected joint
- •This code is appropriate for reactive arthritis following gastrointestinal infection
Clinical Significance
Postdysenteric arthropathy of the right hip represents a severe form of reactive arthritis that can significantly impair mobility and weight-bearing activities. This condition develops following dysentery infection and requires ongoing management due to its chronic inflammatory nature and potential for substantial functional disability.
Documentation Requirements
- ✓History of dysentery or severe infectious diarrheal illness
- ✓Right hip joint involvement specifically documented
- ✓Evidence of hip arthropathy (pain, stiffness, decreased range of motion)
- ✓Temporal relationship between infection and hip symptoms
- ✓Chronic or persistent nature of joint inflammation
- ✓Functional assessment of mobility and weight-bearing capacity
- ✓Physical examination findings consistent with hip arthritis
Commonly Confused Codes
- •M02.152 — Postdysenteric arthropathy, left hip (opposite laterality)
- •M02.159 — Postdysenteric arthropathy, unspecified hip (when side not specified)
- •M00.051 — Staphylococcal arthritis, right hip (direct infection, not reactive)
- •M16.11 — Unilateral primary osteoarthritis, right hip (degenerative, not infectious)
- •M06.851 — Other specified rheumatoid arthritis, right hip (autoimmune etiology)