M87.275
BillableOsteonecrosis due to previous trauma, left foot
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.275 an HCC code?
Yes. M87.275 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 M87.275
For M87.275 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 M87.275 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.275 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, left foot. Death of bone tissue in the left foot caused by a previous injury or trauma. M87.275 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, M87.275 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, M87.275 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.
Ensure documentation clearly indicates 'left foot' and the osteonecrosis is trauma-related. Because M87.275 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 M87.275 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure documentation clearly indicates 'left foot' and the osteonecrosis is trauma-related
- •Review whether condition affects multiple foot structures or is localized to one area
Clinical Significance
Left foot osteonecrosis secondary to trauma represents complex bone pathology affecting weight-bearing function and mobility. This condition can significantly impact patient quality of life and may require multidisciplinary management including orthopedic surgery, podiatric care, and rehabilitation services.
Documentation Requirements
- ✓Clear identification of left foot involvement
- ✓Documentation of previous trauma to left foot area
- ✓Evidence of bone necrosis in left foot structures
- ✓Specific affected bones within foot when documented
- ✓Current weight-bearing ability and ambulation status
- ✓Pain assessment and functional capacity evaluation
- ✓Treatment modalities attempted and effectiveness
- ✓Impact on patient mobility and independence