What is ICD-10 code M86.041?

M86.041 is the ICD-10-CM diagnosis code for Acute hematogenous osteomyelitis, right hand. A bone infection in the right hand caused by bacteria spreading through the bloodstream, typically affecting the small bones of the hand. M86.041 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. M86.041 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. M86.041 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. M86.041 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.

What is the V28 vs V24 difference for M86.041?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For M86.041, V28 maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis at RAF 0.479 while V24 mapped to Bone/Joint/Muscle Infections/Necrosis at RAF 0.401. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting M86.041?

Ensure documentation specifies 'right' hand to use this code; use M86.042 for left This code includes all bones of the right hand; specify which bone if additional detail is needed Because M86.041 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM M86.041: Acute hematogenous

ICD-10-CM Code View

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Code lookupM86.041Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)

M86.041

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Acute hematogenous osteomyelitis, right hand

A bone infection in the right hand caused by bacteria spreading through the bloodstream, typically affecting the small bones of the hand.

Buddy Insight

CMS-HCC V28

Mapped

HCC 92

Bone/Joint/Muscle/Severe Soft...

RAF 0.479

CMS-HCC V24

Mapped

HCC 39

Bone/Joint/Muscle Infections/...

RAF 0.401

ACA/HHS

Mapped

HCC 55

HHS-HCC 55

Varies by metal level

ESRD/PACE

Mapped

HCC 39

Bone/Joint/Muscle Infections/...

RAF 0.092

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

M86.0Acute hematogenous osteomyelitis

M86.04Acute hematogenous osteomyelitis, hand

M86.041Acute hematogenous osteomyelitis, right hand

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M86.041 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M86.041 in this effective period.

Related Child Codes

Official

M86.042Acute hematogenous osteomyelitis, left hand

M86.049Acute hematogenous osteomyelitis, unspecified hand

Includes

Official

ICD-10-CM does not list Includes notes for M86.041 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M86.041 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M86.041 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M86.041 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M86.041 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of acute osteomyelitis affecting right hand bones

Evidence of hematogenous spread to hand structures

Clinical findings of right hand swelling, pain, dysfunction

Imaging studies showing hand bone infection

MEAT Support

HCC Buddy guidance

Documentation of acute osteomyelitis affecting right hand bones

Evidence of hematogenous spread to hand structures

Clinical findings of right hand swelling, pain, dysfunction

Imaging studies showing hand bone infection

Audit Caution

HCC Buddy guidance

Confusing laterality (right vs. left hand)

Using soft tissue infection codes for bone infection

Missing the hematogenous spread mechanism

Confusing with joint infections or cellulitis

Common Mistakes

HCC Buddy guidance

M86042 — Left hand osteomyelitis

M86141 — Other acute osteomyelitis, right hand

M00.841 — Other bacterial arthritis, right hand

L03.111 — Cellulitis of right finger

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 M86.041 an HCC code?

Yes. M86.041 (Acute hematogenous osteomyelitis, right hand) maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24), with a community non-dual aged RAF of 0.479. It is billable for payment year 2026.

Coder answer: M86.041 is billable and maps to V28 HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: M86.041
Description: Acute hematogenous osteomyelitis, right hand
HCC (V28): HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
RAF: 0.479
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis

0.479

V24HCC 39, Bone/Joint/Muscle Infections/Necrosis

0.401

ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis

0.092

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.

Work M86.041 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for M86.041

For M86.041 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 M86.041 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

M86.041 is the ICD-10-CM diagnosis code for acute hematogenous osteomyelitis, right hand. A bone infection in the right hand caused by bacteria spreading through the bloodstream, typically affecting the small bones of the hand. M86.041 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, M86.041 maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.479. Under the older CMS-HCC V24 model, M86.041 maps to Bone/Joint/Muscle Infections/Necrosis (HCC 39) with a community, non-dual, aged base RAF weight of 0.401. 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.

Ensure documentation specifies 'right' hand to use this code; use M86.042 for left. Because M86.041 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 M86.041 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation specifies 'right' hand to use this code; use M86.042 for left
•This code includes all bones of the right hand; specify which bone if additional detail is needed

Clinical Significance

Acute hematogenous osteomyelitis of the right hand represents serious bloodstream-spread infection to the complex small bones of the hand, requiring immediate intensive treatment to prevent permanent functional disability. This location poses high risk for compartment syndrome, joint involvement, and loss of fine motor function essential for daily activities.