M85.361
BillableOsteitis condensans, right lower leg
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M85.361 an HCC code?
No. M85.361 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
M85.361 is the ICD-10-CM diagnosis code for osteitis condensans, right lower leg. A condition where bone becomes abnormally dense and hardened in the right lower leg, typically occurring as a response to inflammation or stress on the bones. M85.361 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).
M85.361 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.
This code specifies the right lower leg; verify laterality in the medical documentation before coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M85.361 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code specifies the right lower leg; verify laterality in the medical documentation before coding
- •The lower leg includes the tibia and fibula; ensure the condition affects this anatomical region