M86.032
BillableAcute hematogenous osteomyelitis, left radius and ulna
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M86.032 an HCC code?
Yes. M86.032 maps to Bone/Joint/Muscle Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for M86.032
For M86.032 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed M86.032 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M86.032 is the ICD-10-CM diagnosis code for acute hematogenous osteomyelitis, left radius and ulna. A serious bone infection of the left forearm bones (radius and ulna) caused by bacteria spreading through the bloodstream. M86.032 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering other osteopathies (m86-m90).
Under the CMS-HCC V28 risk adjustment model, M86.032 maps to Bone/Joint/Muscle Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.209. Under the older V24 model, M86.032 mapped to the same category but with a base RAF weight of 0.482 — V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Verify left side documentation to differentiate from right forearm infection. Because M86.032 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M86.032 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify left side documentation to differentiate from right forearm infection
- •The radius and ulna are the two bones of the forearm between elbow and wrist
Clinical Significance
Acute hematogenous osteomyelitis of left radius and ulna represents serious bloodstream-spread infection affecting both left forearm bones, requiring immediate intensive treatment to prevent devastating functional consequences. This diagnosis indicates high complexity due to dual bone involvement with risks for compartment syndrome and permanent disability.
Documentation Requirements
- ✓Documentation of acute osteomyelitis in left radius and ulna
- ✓Clear evidence of hematogenous spread to both forearm bones
- ✓Clinical examination showing left forearm involvement
- ✓Imaging studies demonstrating infection in both bones
- ✓Microbiological workup with blood and tissue cultures
- ✓Aggressive treatment with IV antibiotics and surgery
- ✓Monitoring for compartment syndrome and vascular compromise