M87.245
BillableOsteonecrosis due to previous trauma, left finger(s)
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.245 an HCC code?
Yes. M87.245 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 M87.245
For M87.245 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 M87.245 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.245 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, left finger(s). Death of bone tissue in one or more fingers on the left hand caused by a previous injury, potentially affecting grip and fine motor function. M87.245 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, M87.245 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, M87.245 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 left-side finger involvement is documented before assigning this code. Because M87.245 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 M87.245 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
Left finger osteonecrosis secondary to trauma significantly affects hand function and dexterity, particularly important if involving the dominant hand. This condition requires specialized hand surgery consultation and comprehensive rehabilitation to optimize functional outcomes and prevent further complications.
Documentation Requirements
- ✓Clear identification of left finger(s) involvement
- ✓Documentation of previous trauma to left finger(s)
- ✓Clinical or radiological evidence of bone death in phalangeal bones
- ✓Specification of which fingers are affected when possible
- ✓Assessment of dominant hand impact
- ✓Current functional limitations and pain assessment
- ✓Treatment history and effectiveness
- ✓Impact on work and activities of daily living
Commonly Confused Codes
- •M87.244 — Osteonecrosis due to previous trauma, right finger(s) (wrong laterality)
- •M87.246 — Osteonecrosis due to previous trauma, unspecified finger(s) (when laterality is documented)
- •M87.242 — Osteonecrosis due to previous trauma, left hand (broader hand involvement)
- •M87.345 — Other secondary osteonecrosis, left finger(s) (non-traumatic secondary cause)
- •M84.344A — Stress fracture, left finger(s) (different pathology)