M79.604
BillablePain in right leg
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M79.604 an HCC code?
No. M79.604 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
M79.604 is the ICD-10-CM diagnosis code for pain in right leg. Pain located in the right leg, which may be caused by muscle strain, overuse, or other soft tissue conditions. M79.604 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering other soft tissue disorders (m70-m79).
M79.604 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.
Verify the specific location of pain (thigh, lower leg, or generalized) for more precise coding if documentation supports it.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M79.604 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific location of pain (thigh, lower leg, or generalized) for more precise coding if documentation supports it
- •Ensure laterality is clearly documented as 'right' to distinguish from left leg pain codes