M85.80 ICD-10-CM Code: Other specified disorders of bone density and structure, unspecified site
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Disorders of bone density and structure (M80-M85)
M85.80
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther specified disorders of bone density and structure, unspecified site
A disorder affecting bone density or structure at an unspecified location in the body.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Hyperostosis of bones, except skull
- Osteosclerosis, acquired
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M85.80 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M85.80 in this effective period.
Excludes 1
Official- diffuse idiopathic skeletal hyperostosis [DISH] (M48.1)
- osteosclerosis congenita (Q77.4)
- osteosclerosis fragilitas (generalista) (Q78.2)
- osteosclerosis myelofibrosis (D75.81)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M85.80 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M85.80 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M85.80 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is M85.80 an HCC code?
No. M85.80 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- M85.80
- Description
- Other specified disorders of bone density and structure, unspecified site
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
M85.80 is the ICD-10-CM diagnosis code for other specified disorders of bone density and structure, unspecified site. A disorder affecting bone density or structure at an unspecified location in the body. M85.80 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).
M85.80 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 is a non-specific code; use only when the exact bone site cannot be determined.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M85.80 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a non-specific code; use only when the exact bone site cannot be determined
- •Query the provider for anatomical location to assign a more specific M85.8x code