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M46.37 ICD-10-CM Code: Infection of intervertebral disc (pyogenic), lumbosacral region

M46.37 maps to CMS-HCC V28 92. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Spondylopathies (M45-M49)

M46.37

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Infection of intervertebral disc (pyogenic), lumbosacral region

A bacterial infection of the intervertebral disc at the junction between the lower back and sacrum (lumbosacral region).

Buddy the Bee presenting code insight

Buddy Insight

Lumbosacral discitis affects the crucial L5-S1 junction, which bears significant mechanical stress and is critical for pelvic stability.

CMS-HCC V28

HCC 92

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 055

Code-level coefficient reference

ESRD/PACE

HCC 39

Code-level coefficient reference

RXHCC

N/A

Not mapped

Code Book Path

Official
M46Other inflammatory spondylopathies
M46.3Infection of intervertebral disc (pyogenic)
M46.37Infection of intervertebral disc (pyogenic), lumbosacral region

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M46.37 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M46.37 in this effective period.

Related Child Codes

Official
M46.30Infection of intervertebral disc (pyogenic), site unspecified
M46.31Infection of intervertebral disc (pyogenic), occipito-atlanto-axial region
M46.32Infection of intervertebral disc (pyogenic), cervical region
M46.33Infection of intervertebral disc (pyogenic), cervicothoracic region
M46.34Infection of intervertebral disc (pyogenic), thoracic region

Includes

Official

ICD-10-CM does not list Includes notes for M46.37 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M46.37 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M46.37 in this effective period.

Use Additional

Official
  • code (B95-B97) to identify infectious agent.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M46.37 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Specific lumbosacral junction location (L5-S1)
Bacterial etiology confirmation
Imaging evidence of L5-S1 disc space infection
Assessment of lumbosacral alignment and stability

MEAT Support

HCC Buddy guidance
Specific lumbosacral junction location (L5-S1)
Bacterial etiology confirmation
Imaging evidence of L5-S1 disc space infection
Assessment of lumbosacral alignment and stability

Audit Caution

HCC Buddy guidance
Choosing pure lumbar or sacral codes instead of junction-specific code
Missing the unique biomechanical challenges of L5-S1 level
Failing to assess sacroiliac joint involvement
Not documenting impact on pelvic stability and gait

Common Mistakes

HCC Buddy guidance
M46.36 — Lumbar region when infection limited to higher lumbar levels
M46.38 — Sacral region when infection primarily sacral
M46.57 — Other infective spondylopathies same region when non-bacterial
M53.3 — Sacrococcygeal disorders when involving coccyx

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 M46.37 an HCC code?

Yes. M46.37 (Infection of intervertebral disc (pyogenic), lumbosacral region) maps to HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.479. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: M46.37 is billable and maps to V28 HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
M46.37
Description
Infection of intervertebral disc (pyogenic), lumbosacral region
HCC (V28)
HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
RAF reference coefficient
0.479
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
0.479
ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work M46.37 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for M46.37

For M46.37 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 M46.37 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

M46.37 is the ICD-10-CM diagnosis code for infection of intervertebral disc (pyogenic), lumbosacral region. A bacterial infection of the intervertebral disc at the junction between the lower back and sacrum (lumbosacral region). M46.37 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering spondylopathies (m45-m49).

Under the CMS-HCC V28 risk adjustment model, M46.37 maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis (HCC 92) with a source-labeled community, non-dual, aged reference coefficient of 0.479. No V24 mapping is shown for M46.37; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Lumbosacral region involves L5-S1 junction; confirm this specific location. Because M46.37 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for M46.37 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Lumbosacral region involves L5-S1 junction; confirm this specific location
  • May present with referred pain to buttocks or lower extremities

Clinical Significance

Lumbosacral discitis affects the crucial L5-S1 junction, which bears significant mechanical stress and is critical for pelvic stability. This location often has compromised blood supply, leading to prolonged healing times and increased risk of chronic complications.

Documentation Requirements

  • Specific lumbosacral junction location (L5-S1)
  • Bacterial etiology confirmation
  • Imaging evidence of L5-S1 disc space infection
  • Assessment of lumbosacral alignment and stability
  • Sacroiliac joint evaluation for extension
  • Lower extremity and pelvic neurological function
  • Gait and mobility assessment
  • Treatment response and functional outcomes

Commonly Confused Codes

  • M46.36: Lumbar region when infection limited to higher lumbar levels
  • M46.38: Sacral region when infection primarily sacral
  • M46.57: Other infective spondylopathies same region when non-bacterial
  • M53.3: Sacrococcygeal disorders when involving coccyx

Child Codes

Code Hierarchy

Because M46.37 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

M46.37 maps to CMS-HCC V28 category 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for M46.37. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work M46.37 in HCC Buddy

Open M46.37 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.