M23.609
BillableOther spontaneous disruption of unspecified ligament of unspecified knee
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M23.609 an HCC code?
No. M23.609 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
M23.609 is the ICD-10-CM diagnosis code for other spontaneous disruption of unspecified ligament of unspecified knee. A spontaneous tear or rupture of a ligament in an unspecified knee that occurred without a specific traumatic event. M23.609 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).
M23.609 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.
Specify laterality when documented; use M23.601 (right) or M23.602 (left) if knee side is identified.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M23.609 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.