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M85.079

Billable

Fibrous dysplasia (monostotic), unspecified ankle and foot

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is M85.079 an HCC code?

No. M85.079 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

M85.079 is the ICD-10-CM diagnosis code for fibrous dysplasia (monostotic), unspecified ankle and foot. A benign bone condition where fibrous tissue abnormally grows in an ankle or foot bone, but the specific side is not documented. M85.079 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).

M85.079 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 M85.079 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 provider if laterality is not specified, as M85.071 or M85.072 would be more specific

Code Hierarchy

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