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M87.246 ICD-10-CM Code: Osteonecrosis due to previous trauma, unspecified finger(s)

M87.246 maps to CMS-HCC V28 92. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupM87.246

FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)

M87.246

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

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.

Buddy the Bee presenting code insight

Buddy Insight

Unspecified finger osteonecrosis following trauma represents localized bone death that can severely impact hand function and quality of life.

CMS-HCC V28

HCC 92

Coefficient HCC 92: 0.479 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 055

Code-level coefficient reference

ESRD/PACE

HCC 39

Code-level coefficient reference

RXHCC

HCC 80

Code-level coefficient reference

Inclusion Terms

Official

No inclusion terms are included in this display for M87.246. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • arthropathic psoriasis (L40.5-)Inherited from M00-M99
  • certain conditions originating in the perinatal period (P04-P96)Inherited from M00-M99
  • certain infectious and parasitic diseases (A00-B99)Inherited from M00-M99
  • compartment syndrome (traumatic) (T79.A-)Inherited from M00-M99
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from M00-M99
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from M00-M99
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from M00-M99
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from M00-M99
  • neoplasms (C00-D49)Inherited from M00-M99
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from M00-M99

Includes

Official
  • avascular necrosis of boneInherited from M87

Excludes 1

Official
  • postprocedural osteopathies (M96.-)Inherited from M86-M90, M87
  • juvenile osteonecrosis (M91-M92)Inherited from M86-M90, M87
  • osteochondropathies (M90-M93)Inherited from M86-M90, M87

Code First

Official

No Code First sequencing instructions are included in this display for M87.246. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code to identify major osseous defect, if applicable (M89.7-)Inherited from M87

Code Also

Official

No Code Also instructions are included in this display for M87.246. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
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)

MEAT Support

HCC Buddy guidance
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)

Audit Caution

HCC Buddy guidance
Using unspecified laterality when documentation clearly indicates right or left
Failing to establish traumatic etiology versus other secondary causes
Expanding to general hand involvement when fingers are specifically documented
Missing bilateral finger involvement that would justify unspecified laterality

Common Mistakes

HCC Buddy guidance
M87.244 — Osteonecrosis due to previous trauma, right finger(s) (when laterality is documented)
M87.245 — Osteonecrosis due to previous trauma, left finger(s) (when laterality is documented)
M87.243 — Osteonecrosis due to previous trauma, unspecified hand (broader anatomical area)
M87.346 — Other secondary osteonecrosis, unspecified finger(s) (non-traumatic cause)

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 M87.246 an HCC code?

Yes. M87.246 (Osteonecrosis due to previous trauma, unspecified finger(s)) maps to HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.479. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: M87.246 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
M87.246
Description
Osteonecrosis due to previous trauma, unspecified finger(s)
HCC (V28)
HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
RAF reference coefficient
0.479
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
0.479
ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis
Not separately weighted
RxHCCHCC 80, Aseptic Necrosis of Bone
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work M87.246 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for M87.246

For M87.246, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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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/Severe Soft Tissue Infections/Necrosis (HCC 92) with a source-labeled community, non-dual, aged reference coefficient of 0.479. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Use only when finger involvement is confirmed but laterality is unspecified. For M87.246, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, 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

Commonly Confused Codes

  • M87.244: Osteonecrosis due to previous trauma, right finger(s) (when laterality is documented)
  • M87.245: Osteonecrosis due to previous trauma, left finger(s) (when laterality is documented)
  • M87.243: Osteonecrosis due to previous trauma, unspecified hand (broader anatomical area)
  • M87.346: Other secondary osteonecrosis, unspecified finger(s) (non-traumatic cause)
  • M25.543: Pain in unspecified finger(s) (symptom without bone necrosis)

Child Codes

Code Hierarchy

Also searched as

  • M87 246
  • M87246

For M87.246, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

M87.246 maps to CMS-HCC V28 category 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for M87.246. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work M87.246 in HCC Buddy

Open M87.246 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.