M85.48
BillableSolitary bone cyst, other site
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M85.48 an HCC code?
No. M85.48 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
M85.48 is the ICD-10-CM diagnosis code for solitary bone cyst, other site. A noncancerous fluid-filled cavity that forms in a bone location not covered by other solitary cyst codes. M85.48 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).
M85.48 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.
Use for solitary cysts in unusual locations such as the spine or pelvis when more specific codes don't apply.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M85.48 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use for solitary cysts in unusual locations such as the spine or pelvis when more specific codes don't apply
- •Document the specific anatomical site in the medical record for clarity