M79.609
BillablePain in unspecified limb
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M79.609 an HCC code?
No. M79.609 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
M79.609 is the ICD-10-CM diagnosis code for pain in unspecified limb. Pain in an unspecified limb when the documentation does not clearly identify whether it is an arm or leg. M79.609 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).
M79.609 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 as a last resort when the limb location cannot be determined from documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M79.609 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code as a last resort when the limb location cannot be determined from documentation
- •Query the provider for clarification on which limb is affected to allow for more specific coding