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M08.072 ICD-10-CM Code: Unspecified juvenile rheumatoid arthritis, left ankle and foot

M08.072 maps to CMS-HCC V28 93. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Inflammatory polyarthropathies (M05-M14)

M08.072

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Unspecified juvenile rheumatoid arthritis, left ankle and foot

A type of arthritis that develops in children, affecting the left ankle and foot joints, causing inflammation and joint damage.

Buddy the Bee presenting code insight

Buddy Insight

This diagnosis represents juvenile rheumatoid arthritis with specific involvement of the left ankle and foot, a chronic inflammatory condition that significantly affects mobility and weight-bearing in pediatric patients.

CMS-HCC V28

HCC 93

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 056

Code-level coefficient reference

ESRD/PACE

HCC 40

Code-level coefficient reference

RXHCC

HCC 83

Code-level coefficient reference

Code Book Path

Official
M08.0Unspecified juvenile rheumatoid arthritis
M08.07Unspecified juvenile rheumatoid arthritis, ankle and foot
M08.072Unspecified juvenile rheumatoid arthritis, left ankle and foot

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M08.072 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M08.072 in this effective period.

Related Child Codes

Official
M08.071Unspecified juvenile rheumatoid arthritis, right ankle and foot
M08.079Unspecified juvenile rheumatoid arthritis, unspecified ankle and foot

Includes

Official

ICD-10-CM does not list Includes notes for M08.072 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M08.072 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M08.072 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M08.072 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M08.072 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Physician documentation of juvenile rheumatoid arthritis diagnosis
Specific involvement of left ankle and foot joints documented
Patient age at onset recorded as under 16 years
Clinical evidence of chronic inflammatory joint disease

MEAT Support

HCC Buddy guidance
Physician documentation of juvenile rheumatoid arthritis diagnosis
Specific involvement of left ankle and foot joints documented
Patient age at onset recorded as under 16 years
Clinical evidence of chronic inflammatory joint disease

Audit Caution

HCC Buddy guidance
Using unspecified codes when specific laterality is documented
Confusing with adult rheumatoid arthritis codes
Failing to recognize combined ankle and foot involvement
Coding mechanical foot problems as inflammatory arthritis

Common Mistakes

HCC Buddy guidance
M08071 — Right ankle and foot involvement instead of left
M08079 — Unspecified ankle/foot when left side documented
M06.872 — Adult RA of left ankle/foot for patients over 16
M25.572 — Left ankle pain without inflammatory arthritis

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is M08.072 an HCC code?

Yes. M08.072 (Unspecified juvenile rheumatoid arthritis, left ankle and foot) maps to HCC 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.617. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: M08.072 is billable and maps to V28 HCC 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
M08.072
Description
Unspecified juvenile rheumatoid arthritis, left ankle and foot
HCC (V28)
HCC 93 — Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
RAF reference coefficient
0.617
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders
0.617
ESRDHCC 40, Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
Not separately weighted
RxHCCHCC 83, Rheumatoid Arthritis and Other Inflammatory Polyarthropathy
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work M08.072 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for M08.072

For M08.072 to 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 M08.072 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

M08.072 is the ICD-10-CM diagnosis code for unspecified juvenile rheumatoid arthritis, left ankle and foot. A type of arthritis that develops in children, affecting the left ankle and foot joints, causing inflammation and joint damage. M08.072 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering inflammatory polyarthropathies (m05-m14).

Under the CMS-HCC V28 risk adjustment model, M08.072 maps to Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders (HCC 93) with a source-labeled community, non-dual, aged reference coefficient of 0.617. No V24 mapping is shown for M08.072; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Ensure documentation specifies left ankle and/or foot to distinguish from right-sided involvement. Because M08.072 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for M08.072 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Ensure documentation specifies left ankle and/or foot to distinguish from right-sided involvement
  • This single code covers all left ankle and foot joint involvement

Clinical Significance

This diagnosis represents juvenile rheumatoid arthritis with specific involvement of the left ankle and foot, a chronic inflammatory condition that significantly affects mobility and weight-bearing in pediatric patients. The condition requires specialized orthopedic care and may impact normal growth and development.

Documentation Requirements

  • Physician documentation of juvenile rheumatoid arthritis diagnosis
  • Specific involvement of left ankle and foot joints documented
  • Patient age at onset recorded as under 16 years
  • Clinical evidence of chronic inflammatory joint disease
  • Assessment of left ankle and foot function and mobility
  • Documentation of inflammatory markers and disease activity
  • Treatment plan including DMARDs or biologic therapy
  • Physical therapy evaluation for mobility optimization

Commonly Confused Codes

  • M08071: Right ankle and foot involvement instead of left
  • M08079: Unspecified ankle/foot when left side documented
  • M06.872: Adult RA of left ankle/foot for patients over 16
  • M25.572: Left ankle pain without inflammatory arthritis
  • M08.09: Multiple site JRA when only left ankle/foot affected

Child Codes

Code Hierarchy

Because M08.072 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

M08.072 maps to CMS-HCC V28 category 93, Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for M08.072. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work M08.072 in HCC Buddy

Open M08.072 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.