M87.246
BillableOsteonecrosis due to previous trauma, unspecified finger(s)
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.246 an HCC code?
Yes. M87.246 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 M87.246
For M87.246 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 M87.246 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.246 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, unspecified finger(s). Death of bone tissue in one or more fingers caused by a previous injury when the specific side (left or right) is not documented or specified. M87.246 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, M87.246 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, M87.246 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.
Use only when finger involvement is confirmed but laterality is unspecified. Because M87.246 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 M87.246 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use only when finger involvement is confirmed but laterality is unspecified
- •Query provider to determine which hand is affected for more precise coding
Clinical Significance
Unspecified finger osteonecrosis following trauma represents localized bone death that can severely impact hand function and quality of life. This condition often requires multidisciplinary management including orthopedic surgery, hand therapy, and pain management to achieve optimal outcomes.
Documentation Requirements
- ✓Documentation of finger involvement without specified laterality
- ✓Clear history of previous trauma to finger(s)
- ✓Evidence of bone necrosis in phalangeal structures
- ✓Justification for unspecified laterality (bilateral involvement or unclear documentation)
- ✓Current functional assessment and range of motion
- ✓Pain levels and grip strength evaluation
- ✓Treatment modalities attempted and response
- ✓Impact on daily activities and occupational function