M87.150 ICD-10-CM Code: Osteonecrosis due to drugs, pelvis
M87.150 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)
M87.150
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOsteonecrosis due to drugs, pelvis
Death of bone tissue in the pelvis caused by medication side effects, which can affect mobility and weight-bearing capacity.
Buddy Insight
Drug-induced osteonecrosis of the pelvis represents a severe medication-related complication affecting weight-bearing capacity and mobility.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
MappedHCC 39
RAF 0.401
ACA/HHS
MappedHCC 55
Varies by metal level
ESRD/PACE
MappedHCC 39
RAF 0.092
RXHCC
MappedHCC 80
RAF 0.204
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M87.150 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M87.150 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M87.150 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M87.150 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M87.150 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M87.150 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M87.150 in this effective period.
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 M87.150 an HCC code?
Yes. M87.150 maps to Bone/Joint/Muscle Infections/Necrosis under the V24 model but is not retained in V28.
- Code
- M87.150
- Description
- Osteonecrosis due to drugs, pelvis
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 M87.150 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for M87.150
For M87.150 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 M87.150 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
M87.150 is the ICD-10-CM diagnosis code for osteonecrosis due to drugs, pelvis. Death of bone tissue in the pelvis caused by medication side effects, which can affect mobility and weight-bearing capacity. M87.150 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 older CMS-HCC V24 model, M87.150 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.
Pelvic osteonecrosis is less common than femoral involvement; verify diagnosis with imaging reports (MRI or CT). Because M87.150 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 M87.150 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Pelvic osteonecrosis is less common than femoral involvement; verify diagnosis with imaging reports (MRI or CT)
- •Document the specific medication and duration of use that led to this drug-induced complication
Clinical Significance
Drug-induced osteonecrosis of the pelvis represents a severe medication-related complication affecting weight-bearing capacity and mobility. This condition often requires extensive orthopedic intervention and can significantly impact quality of life, making it a high-priority diagnosis for comprehensive care management.
Documentation Requirements
- ✓Clear documentation of pelvic bone involvement in osteonecrosis
- ✓Identification of causative medication with exposure details
- ✓Advanced imaging confirming pelvic osteonecrosis (MRI or CT)
- ✓Assessment of weight-bearing capacity and mobility limitations
- ✓Documentation of pain severity and functional impact
- ✓Drug therapy duration and relationship to symptom development
- ✓Treatment plan including weight-bearing restrictions and interventions
- ✓Provider statement establishing drug-induced etiology
Commonly Confused Codes
- •M87.151/M87.152: Hip/femur osteonecrosis involves different bone structures
- •M87.250: Post-traumatic pelvic osteonecrosis requires injury history
- •M87.050: Idiopathic pelvic osteonecrosis lacks drug causation
- •S32.9: Acute pelvic fracture is traumatic injury, not chronic necrosis
- •M87.9: Unspecified osteonecrosis lacks anatomical and etiological specificity