M85.512
BillableAneurysmal bone cyst, left shoulder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M85.512 an HCC code?
No. M85.512 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
M85.512 is the ICD-10-CM diagnosis code for aneurysmal bone cyst, left shoulder. A benign bone cyst filled with blood that develops in the left shoulder area, causing a fluid-filled cavity within the bone. M85.512 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).
M85.512 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 laterality is documented as left shoulder in the medical record before assigning this code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M85.512 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify laterality is documented as left shoulder in the medical record before assigning this code
- •Aneurysmal bone cysts are benign lesions; do not confuse with malignant bone tumors