M61.178
BillableMyositis ossificans progressiva, left toe(s)
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M61.178 an HCC code?
No. M61.178 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
M61.178 is the ICD-10-CM diagnosis code for myositis ossificans progressiva, left toe(s). A rare genetic condition where muscle tissue gradually turns into bone in the left toe(s), causing progressive stiffness and loss of movement. M61.178 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).
M61.178 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 left toe(s) involvement is clearly documented in the medical record.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M61.178 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure left toe(s) involvement is clearly documented in the medical record
- •Note which toes are affected as this impacts functional status and treatment planning