M87.074
BillableIdiopathic aseptic necrosis of right foot
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.074 an HCC code?
Yes. M87.074 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 M87.074
For M87.074to 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 M87.074 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.074 is the ICD-10-CM diagnosis code for idiopathic aseptic necrosis of right foot. Death of bone tissue in the right foot without infection, occurring without a known cause. M87.074 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, M87.074 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, M87.074 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.
Ensure documentation specifies 'right foot' to use this laterality-specific code. Because M87.074 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 M87.074 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation specifies 'right foot' to use this laterality-specific code
- •This code applies to the foot as a whole; use more specific codes if only certain tarsal bones are affected
Clinical Significance
Idiopathic aseptic necrosis of the right foot represents bone death without infection in the complex structures of the right foot, occurring without identifiable cause. This condition can severely impact weight-bearing function and mobility, potentially requiring specialized podiatric or orthopedic intervention to preserve foot structure and prevent progression to deformity.
Documentation Requirements
- ✓Documentation of aseptic necrosis affecting right foot bones
- ✓Evidence of idiopathic etiology (no known cause)
- ✓Imaging confirmation of foot bone necrosis
- ✓Specification of which foot bones are affected when possible
- ✓Exclusion of trauma, vascular, or drug-related causes
- ✓Assessment of weight-bearing capacity and ambulation
- ✓Documentation ruling out infectious foot conditions
- ✓Treatment plan addressing foot structure preservation