M86.422

Billable

Chronic osteomyelitis with draining sinus, left 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 long-term bone infection in the left upper arm bone (humerus) with an open drainage tract that allows infected material to drain through the skin.

Coding Tips

•Confirm laterality is documented as left; if right is documented, use M86.421 instead
•Document the presence of active drainage or sinus tract formation to support this specific code

Clinical Significance

This diagnosis represents chronic osteomyelitis with draining sinus of the left humerus, a complex condition combining persistent bone infection with active drainage requiring specialized treatment. The humerus involvement significantly impacts left arm function and daily activities.

Documentation Requirements

✓Clear documentation of left humerus involvement
✓Evidence supporting chronic nature (duration >6 weeks or recurrent)
✓Confirmation of active draining sinus tract
✓Radiographic studies showing chronic osteomyelitic changes
✓Functional assessment of left arm and drainage characteristics
✓Laboratory findings consistent with chronic infection
✓Treatment documentation for both infection and drainage
✓Clinical correlation with chronic osteomyelitis with draining sinus

Commonly Confused Codes

M86.522 — Other chronic hematogenous osteomyelitis, left humerus, no drainage M86.421 — Same condition but right-sided humerus M86.322 — Chronic multifocal osteomyelitis, left humerus, no drainage M86.122 — Acute osteomyelitis of left humerus, acute presentation L02.422 — Cutaneous abscess of left upper limb, superficial infection

Code Hierarchy

└M86Osteomyelitis └M86.4Chronic osteomyelitis with draining sinus └M86.42Chronic osteomyelitis with draining sinus, humerus └M86.422Chronic osteomyelitis with draining sinus, left humerus

└M86.422Chronic osteomyelitis with draining sinus, left humerus