M61.369
BillableCalcification and ossification of muscles associated with burns, unspecified lower leg
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M61.369 an HCC code?
No. M61.369 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
M61.369 is the ICD-10-CM diagnosis code for calcification and ossification of muscles associated with burns, unspecified lower leg. Hardening and bone formation in muscles of the lower leg as a result of burn injury, when the specific side (left or right) is not specified or documented. M61.369 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).
M61.369 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 cannot be determined from documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M61.369 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 cannot be determined from documentation
- •Query the provider if possible to obtain specific laterality information for more precise coding