M02.152
BillablePostdysenteric arthropathy, left hip
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M02.152 an HCC code?
Yes. M02.152 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 M02.152
For M02.152to 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 M02.152 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M02.152 is the ICD-10-CM diagnosis code for postdysenteric arthropathy, left hip. Joint inflammation and pain in the left hip that develops after a dysentery infection (severe diarrheal illness). M02.152 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, M02.152 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, M02.152 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 clearly identifies left hip as the site of postdysenteric arthropathy. Because M02.152 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 M02.152 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly identifies left hip as the site of postdysenteric arthropathy
- •Consider whether patient has bilateral involvement, which would require separate codes
Clinical Significance
This diagnosis identifies postdysenteric arthropathy specifically affecting the left hip, a chronic reactive arthritis that can severely impact mobility and quality of life. The condition represents a serious post-infectious complication requiring ongoing management and monitoring for functional decline and disability.
Documentation Requirements
- ✓Documented history of dysentery or severe diarrheal infection
- ✓Left hip joint involvement specifically identified
- ✓Clinical evidence of hip arthropathy and functional impairment
- ✓Established timeline between infection and hip arthritis onset
- ✓Chronic or ongoing nature of joint symptoms
- ✓Mobility assessment and weight-bearing status
- ✓Physical examination findings supporting hip arthritis diagnosis
Commonly Confused Codes
- •M02.151 — Postdysenteric arthropathy, right hip (opposite side)
- •M02.159 — Postdysenteric arthropathy, unspecified hip (when laterality unknown)
- •M00.052 — Staphylococcal arthritis, left hip (septic arthritis, not reactive)
- •M16.12 — Unilateral primary osteoarthritis, left hip (degenerative disease)
- •M25.552 — Pain in left hip (symptom code, not diagnostic)