Question 1

What is ICD-10 code M85.632?

Accepted Answer

M85.632 is the ICD-10-CM diagnosis code for other cyst of bone, left forearm. A fluid-filled cavity or sac that forms in the bone of the left forearm, which may or may not cause symptoms depending on its size and location. M85.632 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).

M85.632 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 forearm in the medical record before assigning this code.

Question 2

Is M85.632 an HCC code?

Accepted Answer

No. M85.632 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is M85.632 billable?

Accepted Answer

Yes. M85.632 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M85.632 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for M85.632?

Accepted Answer

M85.632 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards M85.632 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting M85.632?

Accepted Answer

Verify laterality is documented as left forearm in the medical record before assigning this code Distinguish between simple bone cysts and other types of bone cysts, as simple cysts have their own specific codes (M85.40-M85.50)

M85.632

Is M85.632 an HCC code?

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