M85.122
BillableSkeletal fluorosis, left upper arm
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M85.122 an HCC code?
No. M85.122 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
M85.122 is the ICD-10-CM diagnosis code for skeletal fluorosis, left upper arm. A condition where fluorine accumulates in the bones of the left upper arm, causing increased bone density and potential stiffness or pain. M85.122 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).
M85.122 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.
Ensure documentation clearly indicates left-sided involvement to distinguish from the right-sided variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M85.122 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly indicates left-sided involvement to distinguish from the right-sided variant
- •Consider documenting the degree of skeletal fluorosis severity if available in imaging or clinical notes