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M85.1 ICD-10-CM Code: Skeletal fluorosis

M85.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupM85.1

FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Disorders of bone density and structure (M80-M85)

M85.1

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Skeletal fluorosis

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for M85.1. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • arthropathic psoriasis (L40.5-)Inherited from M00-M99
  • certain conditions originating in the perinatal period (P04-P96)Inherited from M00-M99
  • certain infectious and parasitic diseases (A00-B99)Inherited from M00-M99
  • compartment syndrome (traumatic) (T79.A-)Inherited from M00-M99
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from M00-M99
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from M00-M99
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from M00-M99
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from M00-M99
  • neoplasms (C00-D49)Inherited from M00-M99
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from M00-M99

Includes

Official

No Includes notes are included in this display for M85.1. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • osteogenesis imperfecta (Q78.0)Inherited from M85
  • osteopetrosis (Q78.2)Inherited from M85
  • osteopoikilosis (Q78.8)Inherited from M85
  • polyostotic fibrous dysplasia (Q78.1)Inherited from M85

Code First

Official

No Code First sequencing instructions are included in this display for M85.1. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for M85.1. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for M85.1. Check the code and parent instructions in the Code Book.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
M85.1
Description
Skeletal fluorosis
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

M85.1 is the ICD-10-CM diagnosis code for skeletal fluorosis. M85.1 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).

Header codes like M85.1 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for M85.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

Also searched as

  • M85 1
  • M851

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