Question 1

What is ICD-10 code M19.071?

Accepted Answer

M19.071 is the ICD-10-CM diagnosis code for primary osteoarthritis, right ankle and foot. Wear and tear arthritis in the right ankle and foot caused by aging and joint use over time. M19.071 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering osteoarthritis (m15-m19).

M19.071 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Confirm right ankle and/or foot is specifically documented.

Question 2

Is M19.071 an HCC code?

Accepted Answer

No. M19.071 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is M19.071 billable?

Accepted Answer

Yes. M19.071 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M19.071 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for M19.071?

Accepted Answer

M19.071 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards M19.071 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting M19.071?

Accepted Answer

Confirm right ankle and/or foot is specifically documented This code includes both ankle and foot joints; document which joints are affected for clarity

HCC Buddy Code Card

M19.071

Is M19.071 an HCC code?

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Open M19.071 in the Interactive Encoder

M19.071 ICD-10-CM Code: Primary osteoarthritis, right ankle and foot

HCC Buddy Code Card

M19.071

Is M19.071 an HCC code?

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Open M19.071 in the Interactive Encoder