M87.146 ICD-10-CM Code: Osteonecrosis due to drugs, unspecified finger(s)
M87.146 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)
M87.146
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOsteonecrosis due to drugs, unspecified finger(s)
Death of bone tissue in the fingers caused by medication side effects when the specific hand is not documented or cannot be determined.
Buddy Insight
Drug-induced osteonecrosis of unspecified fingers represents medication-related bone death when the affected hand cannot be determined from documentation.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 055
Code-level coefficient reference
ESRD/PACE
MappedHCC 39
Code-level coefficient reference
RXHCC
MappedHCC 80
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for M87.146. Check the code and parent instructions in the Code Book.
Excludes 2
Official- arthropathic psoriasis (L40.5-)Inherited from M00-M99
- certain conditions originating in the perinatal period (P04-P96)Inherited from M00-M99
- certain infectious and parasitic diseases (A00-B99)Inherited from M00-M99
- compartment syndrome (traumatic) (T79.A-)Inherited from M00-M99
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from M00-M99
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from M00-M99
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from M00-M99
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from M00-M99
- neoplasms (C00-D49)Inherited from M00-M99
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from M00-M99
Related Codes
Includes
Official- avascular necrosis of boneInherited from M87
Excludes 1
Official- postprocedural osteopathies (M96.-)Inherited from M86-M90, M87
- juvenile osteonecrosis (M91-M92)Inherited from M86-M90, M87
- osteochondropathies (M90-M93)Inherited from M86-M90, M87
Code First
OfficialNo Code First sequencing instructions are included in this display for M87.146. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify major osseous defect, if applicable (M89.7-)Inherited from M87, M87.1
- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)Inherited from M87, M87.1
Code Also
OfficialNo Code Also instructions are included in this display for M87.146. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 M87.146 an HCC code?
M87.146 is not in the CMS-HCC V28 or V24 community payment model. M87.146 has a separate mapping under the CMS-HCC ESRD model (HCC 39 (Bone/Joint/Muscle Infections/Necrosis)) and the Part D RxHCC model (HCC 80 (Aseptic Necrosis of Bone)); the applicable result needs member context. M87.146 also appears in the HHS-HCC commercial risk model (HCC 055 (HHS-HCC 055 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.
- Code
- M87.146
- Description
- Osteonecrosis due to drugs, unspecified finger(s)
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work M87.146 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for M87.146
For M87.146, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
M87.146 is the ICD-10-CM diagnosis code for osteonecrosis due to drugs, unspecified finger(s). Death of bone tissue in the fingers caused by medication side effects when the specific hand is not documented or cannot be determined. M87.146 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).
M87.146 has no mapping under the CMS-HCC V28 or V24 community payment models. M87.146 has a separate mapping under the CMS-HCC ESRD model (HCC 39 (Bone/Joint/Muscle Infections/Necrosis)) and the Part D RxHCC model (HCC 80 (Aseptic Necrosis of Bone)); the applicable result needs member context. M87.146 also appears in the HHS-HCC commercial risk model (HCC 055 (HHS-HCC 055 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Use only when laterality is truly unspecified; attempt to clarify with provider documentation before defaulting to this code.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for M87.146 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use only when laterality is truly unspecified; attempt to clarify with provider documentation before defaulting to this code
- •Ensure the medication responsible for the osteonecrosis is documented in the patient's medication history
Clinical Significance
Drug-induced osteonecrosis of unspecified fingers represents medication-related bone death when the affected hand cannot be determined from documentation. This condition still requires specialized hand care and may significantly impact fine motor function regardless of laterality specification.
Documentation Requirements
- ✓Documentation confirming finger involvement in osteonecrosis
- ✓Specific causative medication or drug class identification
- ✓Imaging studies demonstrating finger bone necrosis
- ✓Functional assessment of fine motor skills and grip function
- ✓Explanation for why finger laterality cannot be determined
- ✓Drug exposure history with temporal relationship to symptoms
- ✓Treatment approach addressing functional preservation
- ✓Provider confirmation of drug-induced etiology
Commonly Confused Codes
- •M87.144/M87.145: Use specific laterality when right/left is documented
- •M87.143: Unspecified hand includes broader involvement than just fingers
- •M87.246: Post-traumatic unspecified finger requires injury history
- •M87.046: Idiopathic finger osteonecrosis lacks drug causation
- •S62.6: Acute finger injury is traumatic, not chronic drug-induced