M60.811
BillableOther myositis, right shoulder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M60.811 an HCC code?
No. M60.811 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
M60.811 is the ICD-10-CM diagnosis code for other myositis, right shoulder. Inflammation of muscle tissue in the right shoulder, not caused by infection or other specified conditions. M60.811 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).
M60.811 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.
Verify right shoulder is documented; distinguish from left shoulder (M60.812) and other shoulder conditions.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M60.811 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify right shoulder is documented; distinguish from left shoulder (M60.812) and other shoulder conditions
- •Document the underlying cause if known (trauma, overuse, autoimmune) for complete clinical documentation