M02.831
BillableOther reactive arthropathies, right wrist
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M02.831 an HCC code?
Yes. M02.831 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 M02.831
For M02.831to 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 M02.831 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M02.831 is the ICD-10-CM diagnosis code for other reactive arthropathies, right wrist. Joint inflammation of the right wrist caused by a reaction to infection elsewhere in the body. M02.831 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, M02.831 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, M02.831 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 indicates right wrist involvement. Because M02.831 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 M02.831 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly indicates right wrist involvement
- •Reactive arthropathies of the wrist may present with swelling and limited range of motion
Clinical Significance
This diagnosis indicates reactive arthropathy specifically affecting the right wrist, representing joint inflammation secondary to a remote infectious process. The wrist location can significantly impact hand function and activities of daily living, making proper diagnosis and treatment crucial for maintaining patient mobility and quality of life.
Documentation Requirements
- ✓Clinical evidence of right wrist joint inflammation (swelling, pain, stiffness, warmth)
- ✓Documentation of reactive nature - inflammation secondary to remote infection
- ✓Specific anatomical location identified as right wrist joint
- ✓Evidence ruling out direct septic arthritis or other infectious arthropathies
- ✓Documentation of triggering infection or infectious process (if identified)
- ✓Physical examination findings consistent with wrist arthritis
- ✓Exclusion of other arthropathy types (rheumatoid, osteoarthritis, crystal arthropathy)
- ✓Assessment of functional impact on hand/wrist mobility
Commonly Confused Codes
- •M00.032 — Staphylococcal arthritis of right wrist (infectious vs reactive)
- •M06.032 — Rheumatoid arthritis of right wrist (autoimmune vs reactive)
- •M19.032 — Primary osteoarthritis of right wrist (degenerative vs reactive)
- •M02.832 — Other reactive arthropathies, left wrist (laterality difference)
- •M25.532 — Pain in right wrist (symptom vs specific arthropathy diagnosis)