M87.241
BillableOsteonecrosis due to previous trauma, right hand
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.241 an HCC code?
Yes. M87.241 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 M87.241
For M87.241 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 M87.241 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.241 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, right hand. Death of bone tissue in the right hand caused by a previous injury, affecting the overall structure and function of the hand. M87.241 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, M87.241 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, M87.241 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.
This code is broader than finger-specific codes; use when osteonecrosis affects multiple hand structures or when specific location is not documented. Because M87.241 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 M87.241 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is broader than finger-specific codes; use when osteonecrosis affects multiple hand structures or when specific location is not documented
- •Differentiate between hand (M87.241) and finger-specific codes (M87.244) based on documentation
Clinical Significance
Right hand osteonecrosis following trauma represents a complex condition affecting multiple bone structures critical for fine motor function and grip strength. This diagnosis indicates significant long-term complications requiring specialized orthopedic intervention and potentially impacting occupational capacity.
Documentation Requirements
- ✓Clear identification of right hand involvement
- ✓Documentation of previous trauma to the right hand
- ✓Clinical or radiological evidence of bone necrosis in hand structures
- ✓Specific bones affected within the hand (metacarpals, phalanges)
- ✓Current functional limitations and pain levels
- ✓Impact on activities of daily living and work performance
- ✓Treatment history and response to interventions
- ✓Any complications or associated conditions