M87.272
BillableOsteonecrosis due to previous trauma, left ankle
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.272 an HCC code?
Yes. M87.272 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 M87.272
For M87.272 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 M87.272 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.272 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, left ankle. Death of bone tissue in the left ankle caused by a previous injury or trauma to that area. M87.272 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, M87.272 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, M87.272 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 documentation specifies 'left ankle' and that osteonecrosis is directly related to prior trauma. Because M87.272 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 M87.272 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies 'left ankle' and that osteonecrosis is directly related to prior trauma
- •Review imaging reports to confirm bone death diagnosis and ensure laterality is clearly documented
Clinical Significance
Left ankle osteonecrosis secondary to trauma represents a serious complication affecting a critical weight-bearing joint, potentially leading to significant disability and chronic pain. This condition requires specialized orthopedic care and may necessitate advanced surgical procedures to preserve joint function.
Documentation Requirements
- ✓Clear identification of left ankle involvement
- ✓Documentation of previous trauma to left ankle area
- ✓Evidence of bone necrosis in left ankle structures
- ✓Assessment of joint stability and range of motion
- ✓Current pain evaluation and functional capacity
- ✓Weight-bearing status and gait assessment
- ✓Treatment modalities attempted and effectiveness
- ✓Impact on patient mobility and independence