Question 1

What is ICD-10 code M62.431?

Accepted Answer

M62.431 is the ICD-10-CM diagnosis code for contracture of muscle, right forearm. A permanent tightening or shortening of the muscle in the right forearm, restricting normal movement and flexibility. M62.431 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).

M62.431 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28, V24, ESRD, or RxHCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Confirm right forearm is specified in the clinical documentation before coding.

Question 2

Is M62.431 an HCC code?

Accepted Answer

No. M62.431 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is M62.431 billable?

Accepted Answer

Yes. M62.431 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M62.431 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does M62.431 map to under V28?

Accepted Answer

M62.431 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What RAF reference is published for M62.431?

Accepted Answer

M62.431 has no separately stated V28 community reference coefficient. Check the current CMS mapping and factor files before using it in any member-score workflow.

Question 6

What is the V28 vs V24 difference for M62.431?

Accepted Answer

M62.431 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards M62.431 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 7

What documentation supports M62.431?

Accepted Answer

Confirm right forearm is specified in the clinical documentation before coding Consider whether the contracture affects specific muscles (flexors vs. extensors) for more detailed clinical documentation M62.431 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

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M62.431

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M62.431 ICD-10-CM Code: Contracture of muscle, right forearm

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M62.431

Is M62.431 an HCC code?

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What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work M62.431 in HCC Buddy