What is ICD-10 code M87.262?

M87.262 is the ICD-10-CM diagnosis code for Osteonecrosis due to previous trauma, left tibia. Death of bone tissue in the left shinbone (tibia) caused by a previous injury or trauma to that area. M87.262 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. M87.262 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. M87.262 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M87.262 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for M87.262?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For M87.262, V28 maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis at RAF 0.479 while V24 mapped to Bone/Joint/Muscle Infections/Necrosis at RAF 0.401. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting M87.262?

Verify left tibia is documented and distinguish from fibula involvement, which uses different codes (M87.264-M87.266) Confirm the causal relationship between prior trauma and current osteonecrosis in the medical record Because M87.262 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM M87.262: Osteonecrosis due

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Code lookupM87.262Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

M87.262

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

Osteonecrosis due to previous trauma, left tibia

Death of bone tissue in the left shinbone (tibia) caused by a previous injury or trauma to that area.

Buddy Insight

Left tibial osteonecrosis secondary to trauma represents a serious complication affecting a primary weight-bearing bone essential for normal ambulation.

CMS-HCC V28

Mapped

HCC 92

Bone/Joint/Muscle/Severe Soft...

RAF 0.479

CMS-HCC V24

Mapped

HCC 39

Bone/Joint/Muscle Infections/...

RAF 0.401

ACA/HHS

Mapped

HCC 55

HHS-HCC 55

Varies by metal level

ESRD/PACE

Mapped

HCC 39

Bone/Joint/Muscle Infections/...

RAF 0.092

RXHCC

Mapped

HCC 80

Bone/Joint/Muscle Infections/...

RAF 0.204

Code Book Path

Official

M87.2Osteonecrosis due to previous trauma

M87.26Osteonecrosis due to previous trauma, tibia and fibula

M87.262Osteonecrosis due to previous trauma, left tibia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M87.262 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M87.262 in this effective period.

Related Child Codes

Official

M87.261Osteonecrosis due to previous trauma, right tibia

M87.263Osteonecrosis due to previous trauma, unspecified tibia

M87.264Osteonecrosis due to previous trauma, right fibula

M87.265Osteonecrosis due to previous trauma, left fibula

M87.266Osteonecrosis due to previous trauma, unspecified fibula

Includes

Official

ICD-10-CM does not list Includes notes for M87.262 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M87.262 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M87.262 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M87.262 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M87.262 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Clear identification of left tibia involvement

Documentation of previous trauma to left lower leg area

Imaging evidence of bone necrosis in left tibial structures

Specific anatomical location within tibia if documented

MEAT Support

HCC Buddy guidance

Clear identification of left tibia involvement

Documentation of previous trauma to left lower leg area

Imaging evidence of bone necrosis in left tibial structures

Specific anatomical location within tibia if documented

Audit Caution

HCC Buddy guidance

Incorrect laterality assignment between left and right tibia

Using unspecified laterality when left side is clearly documented

Failing to identify traumatic versus other secondary etiologies

Confusing with acute tibial stress fractures or other injuries

Common Mistakes

HCC Buddy guidance

M87.261 — Osteonecrosis due to previous trauma, right tibia (wrong laterality)

M87.263 — Osteonecrosis due to previous trauma, unspecified tibia (when laterality is known)

M87.362 — Other secondary osteonecrosis, left tibia (non-traumatic secondary cause)

M84.362A — Stress fracture, left tibia (acute injury versus chronic necrosis)

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 M87.262 an HCC code?

Yes. M87.262 (Osteonecrosis due to previous trauma, left tibia) 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: M87.262 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: M87.262
Description: Osteonecrosis due to previous trauma, left tibia
HCC (V28): HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
RAF: 0.479
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis

0.479

V24HCC 39, Bone/Joint/Muscle Infections/Necrosis

0.401

ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis

0.092

RxHCCHCC 80, Bone/Joint/Muscle Infections/Necrosis

0.204

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 M87.262 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for M87.262

For M87.262 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 M87.262 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

M87.262 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, left tibia. Death of bone tissue in the left shinbone (tibia) caused by a previous injury or trauma to that area. M87.262 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, M87.262 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, M87.262 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 left tibia is documented and distinguish from fibula involvement, which uses different codes (M87.264-M87.266). Because M87.262 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 M87.262 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify left tibia is documented and distinguish from fibula involvement, which uses different codes (M87.264-M87.266)
•Confirm the causal relationship between prior trauma and current osteonecrosis in the medical record

Clinical Significance

Left tibial osteonecrosis secondary to trauma represents a serious complication affecting a primary weight-bearing bone essential for normal ambulation. This condition often requires specialized orthopedic management and may significantly impact patient mobility and independence, necessitating comprehensive rehabilitation.

Documentation Requirements

✓Clear identification of left tibia involvement
✓Documentation of previous trauma to left lower leg area
✓Imaging evidence of bone necrosis in left tibial structures
✓Specific anatomical location within tibia if documented
✓Current weight-bearing ability and gait assessment
✓Pain evaluation and functional capacity assessment
✓Treatment modalities attempted and effectiveness
✓Impact on patient mobility and quality of life

Commonly Confused Codes

•M87.261: Osteonecrosis due to previous trauma, right tibia (wrong laterality)
•M87.263: Osteonecrosis due to previous trauma, unspecified tibia (when laterality is known)
•M87.362: Other secondary osteonecrosis, left tibia (non-traumatic secondary cause)
•M84.362A: Stress fracture, left tibia (acute injury versus chronic necrosis)
•M87.265: Osteonecrosis due to previous trauma, left fibula (different bone)