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M22.3X9

Billable

Other derangements of patella, unspecified knee

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is M22.3X9 an HCC code?

No. M22.3X9 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

M22.3X9 is the ICD-10-CM diagnosis code for other derangements of patella, unspecified knee. A condition where the kneecap is out of place or damaged in an unspecified knee, causing pain and instability. M22.3X9 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering other joint disorders (m20-m25).

M22.3X9 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.

Use this code only when the knee side is not documented; query the provider if laterality is known.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M22.3X9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code only when the knee side is not documented; query the provider if laterality is known
  • This is a more specific code than M22.90, so use it when derangement (displacement/damage) is documented

Code Hierarchy

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