Skip to content
HCC Buddy home

M87.188 ICD-10-CM Code: Osteonecrosis due to drugs, other site

M87.188 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · free HCC coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

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

M87.188

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

Osteonecrosis due to drugs, other site

Bone death caused by medication side effects in body locations not specified elsewhere.

Buddy the Bee presenting code insight

Buddy Insight

Drug-induced osteonecrosis of other sites represents medication-related bone death in locations not specifically categorized elsewhere, requiring immediate assessment of causative agents and treatment modifications.

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

HCC 39

RAF 0.401

ACA/HHS

HCC 55

Varies by metal level

ESRD/PACE

HCC 39

RAF 0.092

RXHCC

HCC 80

RAF 0.204

Code Book Path

Official
M87.1Osteonecrosis due to drugs
M87.18Osteonecrosis due to drugs, other site
M87.188Osteonecrosis due to drugs, other site

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M87.188 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M87.188 in this effective period.

Related Child Codes

Official
M87.180Osteonecrosis due to drugs, jaw

Includes

Official

ICD-10-CM does not list Includes notes for M87.188 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M87.188 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M87.188 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M87.188 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M87.188 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Specific anatomical site documentation (other than standard locations)
Clear identification of drug-induced etiology
Documentation of causative medication(s)
Imaging evidence of osteonecrosis at specified site

MEAT Support

HCC Buddy guidance
Specific anatomical site documentation (other than standard locations)
Clear identification of drug-induced etiology
Documentation of causative medication(s)
Imaging evidence of osteonecrosis at specified site

Audit Caution

HCC Buddy guidance
Using when a more specific anatomical code exists
Not confirming drug-induced etiology with clear documentation
Failing to identify causative medication
Missing specific anatomical site documentation

Common Mistakes

HCC Buddy guidance
M87.088 — Idiopathic osteonecrosis of other site (no drug cause)
M87.288 — Trauma-related osteonecrosis of other site (injury-related)
M87.388 — Other secondary osteonecrosis of other site (different secondary cause)
Specific site drug-induced codes (M87.11x-M87.18x when standard location)

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 M87.188 an HCC code?

Yes. M87.188 maps to Bone/Joint/Muscle Infections/Necrosis under the V24 model but is not retained in V28.

Code
M87.188
Description
Osteonecrosis due to drugs, other site
HCC (V28)
No CMS-HCC V28 mapping
RAF
—
Billable
Yes
Payment year
2026

HCC Category Mapping

V24HCC 39, Bone/Joint/Muscle Infections/Necrosis
0.401
ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis
0.092
RxHCCHCC 80, Bone/Joint/Muscle Infections/Necrosis
0.204

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 M87.188 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for M87.188

For M87.188 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 M87.188 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

M87.188 is the ICD-10-CM diagnosis code for osteonecrosis due to drugs, other site. Bone death caused by medication side effects in body locations not specified elsewhere. M87.188 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, M87.188 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.

Use this code only when the affected bone site does not fit into other M87.1x categories. Because M87.188 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 M87.188 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Use this code only when the affected bone site does not fit into other M87.1x categories
  • •Document the specific anatomical location in the medical record for clarity and future reference

Clinical Significance

Drug-induced osteonecrosis of other sites represents medication-related bone death in locations not specifically categorized elsewhere, requiring immediate assessment of causative agents and treatment modifications. This condition indicates serious medication-related complications that may affect multiple organ systems and require specialized management.

Documentation Requirements

  • ✓Specific anatomical site documentation (other than standard locations)
  • ✓Clear identification of drug-induced etiology
  • ✓Documentation of causative medication(s)
  • ✓Imaging evidence of osteonecrosis at specified site
  • ✓Timeline establishing drug exposure relationship
  • ✓Assessment of functional impact from affected site
  • ✓Evaluation for medication discontinuation or modification
  • ✓Treatment planning with appropriate specialists

Commonly Confused Codes

  • •M87.088: Idiopathic osteonecrosis of other site (no drug cause)
  • •M87.288: Trauma-related osteonecrosis of other site (injury-related)
  • •M87.388: Other secondary osteonecrosis of other site (different secondary cause)
  • •Specific site drug-induced codes (M87.11x-M87.18x when standard location)
  • •M89.8: Other specified disorders of bone (different pathology)

Child Codes

M87.180Osteonecrosis due to drugs, jaw
M87.188Osteonecrosis due to drugs, other site

Code Hierarchy

└M87Osteonecrosis└M87.1Osteonecrosis due to drugs└M87.18Osteonecrosis due to drugs, other site└M87.188Osteonecrosis due to drugs, other site
└M87.188Osteonecrosis due to drugs, other site

Because M87.188 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

Work M87.188 in HCC Buddy

Open M87.188 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

Open in Code BookOpen in EncoderStart Pro