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M85.10

Billable

Skeletal fluorosis, unspecified site

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

Is M85.10 an HCC code?

No. M85.10 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

M85.10 is the ICD-10-CM diagnosis code for skeletal fluorosis, unspecified site. A bone condition caused by excessive fluoride exposure that hardens and thickens bones, with the specific location not documented. M85.10 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).

M85.10 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.

Obtain occupational or environmental history to confirm fluoride exposure source.

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

Coding Tips

  • Obtain occupational or environmental history to confirm fluoride exposure source
  • Use more specific codes (M85.111, M85.112, M85.119, etc.) when the affected site is documented

Code Hierarchy

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