M86.40
BillableChronic osteomyelitis with draining sinus, unspecified site
HCC Category Mapping
V28HCC 92 — Bone/Joint/Muscle Infections/Necrosis
0.209V24HCC 39 — Bone/Joint/Muscle Infections/Necrosis
0.482ESRDHCC 39 — Bone/Joint/Muscle Infections/Necrosis
0.000What This Code Means
A chronic bone infection with an open drainage tract or sinus when the specific location on the body is not documented.
Coding Tips
- •The presence of a draining sinus is a key distinguishing feature of this code category
- •Query provider for anatomical site if not clearly documented
Clinical Significance
Chronic osteomyelitis with draining sinus at an unspecified site represents a severe, persistent bone infection complicated by an open drainage tract, indicating treatment-resistant disease. The presence of a draining sinus significantly complicates treatment and increases risk for recurrent infection and systemic complications.
Documentation Requirements
- ✓Documentation of chronic osteomyelitis with confirmed draining sinus
- ✓Evidence of chronicity (>6 weeks duration or recurrent episodes)
- ✓Description of draining sinus tract characteristics
- ✓Imaging findings showing chronic osteomyelitic changes
- ✓Clinical evidence of persistent drainage from bone infection
- ✓Laboratory findings supporting chronic infectious process
- ✓Treatment history addressing both infection and drainage
- ✓Absence of specific anatomical site documentation
Commonly Confused Codes
M86.60 — Other chronic osteomyelitis, unspecified site, lacks drainageM86.30 — Chronic multifocal osteomyelitis, lacks drainage componentM86.10 — Acute osteomyelitis, differs by chronicityL02.9 — Cutaneous abscess, unspecified, superficial vs bone involvementM86.50 — Other chronic hematogenous osteomyelitis, lacks drainage
Code Hierarchy
└M86Osteomyelitis└M86.4Chronic osteomyelitis with draining sinus└M86.40Chronic osteomyelitis with draining sinus, unspecified site
└M86.40Chronic osteomyelitis with draining sinus, unspecified site