M87.235
BillableOsteonecrosis due to previous trauma of left ulna
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.235 an HCC code?
Yes. M87.235 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 M87.235
For M87.235 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 M87.235 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.235 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma of left ulna. Death of bone tissue in the left forearm bone (ulna) resulting from a previous injury. M87.235 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, M87.235 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, M87.235 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.
Confirm left ulna involvement in the medical record before coding. Because M87.235 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 M87.235 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm left ulna involvement in the medical record before coding
- •Consider imaging findings that support the diagnosis of osteonecrosis
Clinical Significance
Left ulna post-traumatic osteonecrosis significantly impacts forearm biomechanics and may affect the dominant extremity in most patients. This condition represents failed bone healing requiring intensive management to preserve function and prevent progressive collapse.
Documentation Requirements
- ✓Clear documentation of previous trauma to the left ulna
- ✓Radiological confirmation of osteonecrosis in left ulna
- ✓Clinical evidence of left forearm/elbow dysfunction
- ✓Exclusion of non-traumatic causes of bone necrosis
- ✓Documentation of symptoms such as pain or stiffness
- ✓Provider correlation between past injury and current pathology
- ✓Evidence of compromised bone viability through imaging
- ✓Assessment of functional impact on daily activities