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M61.029

Billable

Myositis ossificans traumatica, unspecified upper arm

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

Is M61.029 an HCC code?

No. M61.029 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

M61.029 is the ICD-10-CM diagnosis code for myositis ossificans traumatica, unspecified upper arm. Abnormal bone formation in upper arm muscle tissue caused by trauma, with the specific arm side not specified. M61.029 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).

M61.029 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.

Avoid this unspecified code if documentation indicates right or left; query for clarification.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M61.029 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Avoid this unspecified code if documentation indicates right or left; query for clarification
  • Document the extent of ossification and any functional impairment for clinical completeness

Code Hierarchy

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