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M60.069

Billable

Infective myositis, unspecified lower leg

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

Is M60.069 an HCC code?

No. M60.069 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

M60.069 is the ICD-10-CM diagnosis code for infective myositis, unspecified lower leg. A bacterial or viral infection of the muscle tissue in the lower leg when the specific side (left or right) is not documented or specified. M60.069 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering disorders of muscles (m60-m63).

M60.069 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 laterality is genuinely unspecified in the medical record.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M60.069 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 laterality is genuinely unspecified in the medical record
  • Always attempt to obtain specific laterality information from the provider for accurate coding

Code Hierarchy

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