What is ICD-10 code M86.272?

M86.272 is the ICD-10-CM diagnosis code for Subacute osteomyelitis, left ankle and foot. A bone infection in the left ankle and foot bones that develops gradually over weeks to months. It belongs to the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99). M86.272 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. M86.272 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. M86.272 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. M86.272 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 M86.272?

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 M86.272, 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 M86.272?

Verify left-sided location is clearly stated in the clinical documentation Document any diabetic foot complications or peripheral vascular disease that may be contributing factors Because M86.272 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 M86.272: Subacute osteomyelitis

ICD-10-CM Code View

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Code lookupM86.272Effective 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)

M86.272

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

Subacute osteomyelitis, left ankle and foot

A bone infection in the left ankle and foot bones that develops gradually over weeks to months.

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

M86.2Subacute osteomyelitis

M86.27Subacute osteomyelitis, ankle and foot

M86.272Subacute osteomyelitis, left ankle and foot

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M86.272 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M86.272 in this effective period.

Related Child Codes

Official

M86.271Subacute osteomyelitis, right ankle and foot

M86.279Subacute osteomyelitis, unspecified ankle and foot

Includes

Official

ICD-10-CM does not list Includes notes for M86.272 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M86.272 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M86.272 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M86.272 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M86.272 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of subacute osteomyelitis affecting left ankle and/or foot

Clinical evidence of infection developing over weeks to months

Specific left-sided involvement documented

Radiological confirmation of bone infection in ankle/foot bones

MEAT Support

HCC Buddy guidance

Documentation of subacute osteomyelitis affecting left ankle and/or foot

Clinical evidence of infection developing over weeks to months

Specific left-sided involvement documented

Radiological confirmation of bone infection in ankle/foot bones

Audit Caution

HCC Buddy guidance

Confusing left versus right laterality

Misclassifying disease timeline (subacute vs acute vs chronic)

Applying to cellulitis without confirmed bone involvement

Failing to establish subacute infection criteria

Common Mistakes

HCC Buddy guidance

M86.271 — Use for right ankle and foot involvement

M86.279 — Use when laterality is not documented

M86.072 — Use for acute hematogenous osteomyelitis of left ankle/foot

M86.672 — Use for chronic osteomyelitis of left ankle/foot

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 M86.272 an HCC code?

Yes. M86.272 (Subacute osteomyelitis, left ankle and foot) 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: M86.272 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: M86.272
Description: Subacute osteomyelitis, left ankle and foot
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 M86.272 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for M86.272

For M86.272 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 M86.272 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

M86.272 is the ICD-10-CM diagnosis code for subacute osteomyelitis, left ankle and foot. A bone infection in the left ankle and foot bones that develops gradually over weeks to months. M86.272 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, M86.272 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, M86.272 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.

Verify left-sided location is clearly stated in the clinical documentation. Because M86.272 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 M86.272 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify left-sided location is clearly stated in the clinical documentation
•Document any diabetic foot complications or peripheral vascular disease that may be contributing factors

Clinical Significance

Subacute osteomyelitis of the left ankle and foot is an intermediate-phase bone infection that develops gradually over weeks to months, creating significant functional impairment and risk of progression to chronic infection. The intricate bone structure of the foot requires aggressive treatment to preserve mobility and prevent long-term complications.