M61.174
BillableMyositis ossificans progressiva, right foot
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M61.174 an HCC code?
No. M61.174 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
M61.174 is the ICD-10-CM diagnosis code for myositis ossificans progressiva, right foot. A rare genetic condition where muscle tissue gradually turns into bone in the right foot, causing progressive stiffness and loss of movement. M61.174 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).
M61.174 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.
Ensure documentation specifically indicates the right foot to justify this lateralized code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M61.174 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifically indicates the right foot to justify this lateralized code
- •Track progression over time as this is a degenerative condition that worsens with age