M85.322
BillableOsteitis condensans, left upper arm
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M85.322 an HCC code?
No. M85.322 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
M85.322 is the ICD-10-CM diagnosis code for osteitis condensans, left upper arm. A bone condition where the left upper arm develops increased bone density and hardening, typically affecting the humerus bone. M85.322 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).
M85.322 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.
Verify left-sided involvement is clearly documented before assigning this laterality-specific code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M85.322 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify left-sided involvement is clearly documented before assigning this laterality-specific code
- •Consider the clinical context for why the left upper arm is affected (occupational stress, previous trauma, etc.)