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M23.269

Billable

Derangement of other lateral meniscus due to old tear or injury, unspecified knee

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

Is M23.269 an HCC code?

No. M23.269 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

M23.269 is the ICD-10-CM diagnosis code for derangement of other lateral meniscus due to old tear or injury, unspecified knee. Damage to other parts of the outer cartilage pad (meniscus) from an old tear or injury, affecting an unspecified knee. M23.269 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).

M23.269 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 only when the specific knee cannot be determined from documentation.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M23.269 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use only when the specific knee cannot be determined from documentation
  • Query the provider if laterality is not documented, as M23.261 or M23.262 would be more specific

Code Hierarchy

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