M31.8 ICD-10-CM Code: Other specified necrotizing vasculopathies
M31.8 maps to CMS-HCC V28 94 (RAF 0.268). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Systemic connective tissue disorders (M30-M36)
M31.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther specified necrotizing vasculopathies
Other types of blood vessel inflammation and damage that don't fit into more specific vasculitis categories.
Buddy Insight
This diagnosis represents a serious systemic vasculitis that can affect multiple organ systems and requires ongoing monitoring and treatment.
CMS-HCC V28
MappedHCC 94
RAF 0.268
CMS-HCC V24
MappedHCC 108
RAF 0.288
ACA/HHS
N/A—
Not mapped
ESRD/PACE
MappedHCC 108
RAF 0.073
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Hypocomplementemic vasculitis
- Septic vasculitis
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M31.8 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M31.8 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M31.8 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M31.8 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M31.8 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M31.8 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 M31.8 an HCC code?
Yes. M31.8 (Other specified necrotizing vasculopathies) maps to Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders under the CMS-HCC V28 risk adjustment model (and Vascular Disease under V24), with a community non-dual aged RAF of 0.268. It is billable for payment year 2026.
Coder answer: M31.8 is billable and maps to V28 HCC 94, Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- M31.8
- Description
- Other specified necrotizing vasculopathies
- HCC (V28)
- HCC 94 — Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders
- RAF
- 0.268
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so 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 segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work M31.8 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for M31.8
For M31.8 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 M31.8 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
M31.8 is the ICD-10-CM diagnosis code for other specified necrotizing vasculopathies. Other types of blood vessel inflammation and damage that don't fit into more specific vasculitis categories. M31.8 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering systemic connective tissue disorders (m30-m36).
Under the CMS-HCC V28 risk adjustment model, M31.8 maps to Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders (HCC 94) with a community, non-dual, aged base RAF weight of 0.268. Under the older CMS-HCC V24 model, M31.8 maps to Vascular Disease (HCC 108) with a community, non-dual, aged base RAF weight of 0.288. 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.
Use this code only when the specific type of necrotizing vasculopathy is documented but doesn't fit other M31 codes. Because M31.8 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. 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, RAF weights, and MEAT documentation criteria for M31.8 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 specific type of necrotizing vasculopathy is documented but doesn't fit other M31 codes
- •Include documentation of which blood vessels are affected and what organs are involved for complete coding
Clinical Significance
This diagnosis represents a serious systemic vasculitis that can affect multiple organ systems and requires ongoing monitoring and treatment. The condition significantly impacts patient morbidity and mortality risk, requiring specialized care coordination and frequent monitoring for complications.
Documentation Requirements
- ✓Documentation of necrotizing vasculopathy diagnosis by a rheumatologist or other specialist
- ✓Specific type of vasculopathy that doesn't fit other M31 categories
- ✓Laboratory evidence supporting vasculitis (elevated ESR, CRP, ANCA if applicable)
- ✓Imaging studies showing vascular involvement (angiography, CT, MRI)
- ✓Biopsy results confirming necrotizing inflammation when available
- ✓Documentation of affected organ systems or vessels
- ✓Current treatment regimen and response to therapy
- ✓Any complications or sequelae from the vasculopathy
Commonly Confused Codes
- •M31.9: Use when the type of necrotizing vasculopathy is unspecified rather than a specified other type
- •M31.0-M31.7: Use specific codes when the vasculopathy fits defined categories like polyarteritis nodosa or Wegener's
- •I77.6: Use for arteritis when there's no evidence of necrotizing vasculopathy
- •M35.2: Use for Behçet's disease rather than other specified necrotizing vasculopathies