M02.89
BillableOther reactive arthropathies, multiple sites
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M02.89 an HCC code?
Yes. M02.89 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 M02.89
For M02.89to 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 M02.89 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M02.89 is the ICD-10-CM diagnosis code for other reactive arthropathies, multiple sites. Joint inflammation affecting multiple different sites in the body that develops as a reaction to an infection or other trigger. M02.89 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, M02.89 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, M02.89 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.
Use this code when reactive arthropathy involves three or more different joint sites; list specific affected sites in documentation. Because M02.89 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 M02.89 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when reactive arthropathy involves three or more different joint sites; list specific affected sites in documentation
- •Consider coding individual site-specific codes if only one or two sites are involved, as those are more precise
Clinical Significance
This diagnosis represents reactive arthropathy affecting multiple joint sites simultaneously, indicating widespread inflammation secondary to a remote infectious trigger. Multiple joint involvement suggests a more systemic process with greater functional impact and complexity, requiring comprehensive management and monitoring.
Documentation Requirements
- ✓Clinical evidence of inflammation in multiple joint sites
- ✓Documentation of reactive nature - inflammation secondary to remote infection
- ✓Identification of at least two different anatomical joint sites affected
- ✓Evidence ruling out direct septic arthritis at multiple sites
- ✓Documentation of triggering infection or infectious process (if identified)
- ✓Physical examination findings consistent with polyarthritis
- ✓Exclusion of other systemic arthropathies (rheumatoid arthritis, lupus)
- ✓Assessment of overall functional impact and disability
Commonly Confused Codes
- •M06.9 — Rheumatoid arthritis, unspecified (autoimmune vs reactive polyarthritis)
- •M79.3 — Panniculitis, unspecified (soft tissue vs joint inflammation)
- •M35.9 — Systemic involvement of connective tissue, unspecified (autoimmune vs reactive)
- •Individual site-specific reactive arthropathy codes (when only one site documented)
- •M25.50 — Pain in unspecified joint (symptom vs specific arthropathy diagnosis)