M87.237 ICD-10-CM Code: Osteonecrosis due to previous trauma of right carpus
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)
M87.237
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOsteonecrosis 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.
Buddy Insight
Right carpal osteonecrosis following trauma is particularly significant due to the complex anatomy and critical function of wrist bones in daily activities.
CMS-HCC V28
MappedHCC 92
RAF 0.479
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 M87.237 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M87.237 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M87.237 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M87.237 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M87.237 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M87.237 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M87.237 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 M87.237 an HCC code?
Yes. M87.237 (Osteonecrosis due to previous trauma of right carpus) maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24), with a community non-dual aged RAF of 0.479. It is billable for payment year 2026.
Coder answer: M87.237 is billable and maps to V28 HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- M87.237
- Description
- Osteonecrosis due to previous trauma of right carpus
- HCC (V28)
- HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- RAF
- 0.479
- 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 M87.237 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
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.
Coder workflow notes
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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/Severe Soft Tissue Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.479. Under the older CMS-HCC V24 model, M87.237 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.
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
Commonly Confused Codes
- •M87.238: Osteonecrosis due to previous trauma of left carpus (wrong laterality)
- •M87.239: Osteonecrosis due to previous trauma of unspecified carpus (when laterality is documented)
- •M87.337: Other secondary osteonecrosis of right carpus (non-traumatic cause)
- •M87.241: Osteonecrosis due to previous trauma, right hand (more general hand involvement)
- •S62.109A: Fracture of unspecified carpal bone, right wrist (acute fracture, not osteonecrosis)