M86.029

Billable

Acute hematogenous osteomyelitis, unspecified humerus

HCC Category Mapping

V28HCC 92 — Bone/Joint/Muscle Infections/Necrosis

0.209

V24HCC 39 — Bone/Joint/Muscle Infections/Necrosis

0.482

ESRDHCC 39 — Bone/Joint/Muscle Infections/Necrosis

0.000

What This Code Means

A serious bone infection of the upper arm bone (humerus) caused by bacteria spreading through the bloodstream, but the specific side is not documented.

Coding Tips

•Use only when laterality is truly unknown or not documented in the medical record
•Attempt to clarify with the provider whether the infection is on the right or left side

Clinical Significance

Acute hematogenous osteomyelitis of unspecified humerus represents serious bloodstream-spread bone infection when laterality is not documented, requiring immediate aggressive treatment. This diagnosis indicates potentially incomplete documentation that may benefit from clarification of right vs. left involvement for optimal treatment planning and care coordination.

Documentation Requirements

✓Documentation of acute humeral osteomyelitis without laterality
✓Evidence of hematogenous spread without side specification
✓Clinical findings of upper arm bone infection
✓Imaging studies showing humeral involvement
✓Blood and bone cultures when obtainable
✓Treatment with IV antibiotics and surgical consideration
✓Absence of specific right or left documentation

Commonly Confused Codes

M86021 — Right humerus (when side is documented)M86022 — Left humerus (when side is documented)M86129 — Other acute osteomyelitis, unspecified humerus S42.309A — Fracture of shaft of unspecified humerus M00.829 — Other bacterial arthritis, unspecified elbow

Code Hierarchy

└M86Osteomyelitis └M86.0Acute hematogenous osteomyelitis └M86.02Acute hematogenous osteomyelitis, humerus └M86.029Acute hematogenous osteomyelitis, unspecified humerus

└M86.029Acute hematogenous osteomyelitis, unspecified humerus