M87.237
BillableOsteonecrosis due to previous trauma of right carpus
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.237 an HCC code?
Yes. M87.237 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 M87.237
For M87.237 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 M87.237 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.237 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma of right carpus. Death of bone tissue in the wrist bones on the right side caused by a previous injury, resulting in bone deterioration and potential loss of function. M87.237 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, M87.237 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, M87.237 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.
Verify documentation confirms osteonecrosis is due to previous trauma rather than other causes like radiation or idiopathic. Because M87.237 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 M87.237 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation confirms osteonecrosis is due to previous trauma rather than other causes like radiation or idiopathic
- •Ensure laterality is clearly documented as right before assigning this code
Clinical Significance
Right carpal osteonecrosis following trauma is particularly significant due to the complex anatomy and critical function of wrist bones in daily activities. This condition often leads to chronic pain, limited range of motion, and potential need for specialized orthopedic procedures including bone grafting or joint fusion.
Documentation Requirements
- ✓Specific identification of right carpus involvement
- ✓Documentation of previous trauma to the right wrist area
- ✓Clinical or radiological evidence of bone death in carpal bones
- ✓Description of current symptoms and functional limitations
- ✓History of the traumatic event and timeline
- ✓Any associated complications or secondary conditions
- ✓Treatment modalities attempted or planned
- ✓Impact on activities of daily living and work capacity