M85.069
BillableFibrous dysplasia (monostotic), unspecified lower leg
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M85.069 an HCC code?
No. M85.069 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
M85.069 is the ICD-10-CM diagnosis code for fibrous dysplasia (monostotic), unspecified lower leg. A benign bone condition where fibrous tissue abnormally grows in the lower leg bone, affecting only one bone. M85.069 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering disorders of bone density and structure (m80-m85).
M85.069 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.
Specify laterality when documented; use M85.061 for right leg or M85.062 for left leg if available.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M85.069 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.