What is ICD-10 code M87.162?

M87.162 is the ICD-10-CM diagnosis code for Osteonecrosis due to drugs, left tibia. Death of bone tissue in the left tibia (shin bone) caused by medication side effects, leading to bone deterioration and potential collapse. M87.162 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. M87.162 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. M87.162 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M87.162 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does M87.162 map to under V28?

M87.162 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for M87.162?

M87.162 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for M87.162?

M87.162 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports M87.162?

Verify the specific drug causing osteonecrosis in the medical record and document it for complete coding accuracy Ensure laterality is clearly documented as 'left' to distinguish from right or unspecified tibia codes M87.162 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM M87.162: Osteonecrosis due to drugs, left

M87.162 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupM87.162

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)

M87.162

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Osteonecrosis due to drugs, left tibia

Death of bone tissue in the left tibia (shin bone) caused by medication side effects, leading to bone deterioration and potential collapse.

Buddy Insight

Drug-induced osteonecrosis of the left tibia represents medication-related bone death in the major weight-bearing bone of the lower leg, with potential impact on both knee and ankle joint mechanics.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 055

HHS-HCC 055 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 39

Bone/Joint/Muscle Infections/...

Code-level coefficient reference

RXHCC

Mapped

HCC 80

Aseptic Necrosis of Bone

Code-level coefficient reference

Code Book Path

Official

M87.1Osteonecrosis due to drugs M87.16Osteonecrosis due to drugs, tibia and fibula M87.162Osteonecrosis due to drugs, left tibia

Inclusion Terms

Official

No inclusion terms are included in this display for M87.162. 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

Official

M87.161Osteonecrosis due to drugs, right tibia M87.163Osteonecrosis due to drugs, unspecified tibia M87.164Osteonecrosis due to drugs, right fibula M87.165Osteonecrosis due to drugs, left fibula M87.166Osteonecrosis due to drugs, unspecified fibula

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

Official

No Code First sequencing instructions are included in this display for M87.162. 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

Official

No Code Also instructions are included in this display for M87.162. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Clear documentation of left tibia involvement in osteonecrosis

Specific causative medication with exposure details

Advanced imaging confirming left tibial osteonecrosis

Assessment of lower extremity function and weight-bearing status

MEAT Support

HCC Buddy guidance

Clear documentation of left tibia involvement in osteonecrosis

Specific causative medication with exposure details

Advanced imaging confirming left tibial osteonecrosis

Assessment of lower extremity function and weight-bearing status

Audit Caution

HCC Buddy guidance

Reversing laterality in left/right tibia documentation

Confusing tibial and fibular involvement in lower leg necrosis

Using unspecified codes when laterality is clearly available

Missing drug causation link in complex orthopedic conditions

Common Mistakes

HCC Buddy guidance

M87.161 — Right tibia osteonecrosis, opposite side

M87.163 — Unspecified tibia when left side is documented

M87.165 — Left fibula osteonecrosis affects different lower leg bone

M87.262 — Post-traumatic left tibia requires trauma history

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 M87.162 an HCC code?

M87.162 is not in the CMS-HCC V28 or V24 community payment model. M87.162 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. M87.162 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: M87.162
Description: Osteonecrosis due to drugs, left tibia
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis

Not separately weighted

RxHCCHCC 80, Aseptic Necrosis of Bone

Not separately weighted

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 M87.162 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for M87.162

For M87.162, 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

M87.162 is the ICD-10-CM diagnosis code for osteonecrosis due to drugs, left tibia. Death of bone tissue in the left tibia (shin bone) caused by medication side effects, leading to bone deterioration and potential collapse. M87.162 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).

M87.162 has no mapping under the CMS-HCC V28 or V24 community payment models. M87.162 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. M87.162 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.

Verify the specific drug causing osteonecrosis in the medical record and document it for complete coding accuracy.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for M87.162 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the specific drug causing osteonecrosis in the medical record and document it for complete coding accuracy
•Ensure laterality is clearly documented as 'left' to distinguish from right or unspecified tibia codes

Clinical Significance

Drug-induced osteonecrosis of the left tibia represents medication-related bone death in the major weight-bearing bone of the lower leg, with potential impact on both knee and ankle joint mechanics. This condition requires comprehensive orthopedic evaluation and may necessitate complex surgical intervention to maintain limb function.