M87.277 ICD-10-CM Code: Osteonecrosis due to previous trauma, right toe(s)
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)
M87.277
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOsteonecrosis due to previous trauma, right toe(s)
Death of bone tissue in the right toe(s) caused by a previous injury or trauma.
Buddy Insight
Right toe osteonecrosis following trauma affects the distal weight-bearing structures essential for balance and push-off during ambulation.
CMS-HCC V28
MappedHCC 92
RAF 0.209
CMS-HCC V24
MappedHCC 39
RAF 0.482
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 39
RAF 0.0
RXHCC
MappedHCC 80
RAF 0.0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M87.277 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M87.277 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M87.277 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M87.277 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M87.277 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M87.277 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M87.277 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is M87.277 an HCC code?
Yes. M87.277 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 M87.277
For M87.277to 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 M87.277 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
M87.277 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, right toe(s). Death of bone tissue in the right toe(s) caused by a previous injury or trauma. M87.277 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, M87.277 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, M87.277 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 'right toe(s)' and confirm whether one or multiple toes are affected. Because M87.277 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 M87.277 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies 'right toe(s)' and confirm whether one or multiple toes are affected
- •Use this code specifically for toe involvement rather than general foot osteonecrosis
Clinical Significance
Right toe osteonecrosis following trauma affects the distal weight-bearing structures essential for balance and push-off during ambulation. While involving smaller bones, this condition can significantly impact gait mechanics and may require specialized podiatric or orthopedic management.
Documentation Requirements
- ✓Specific identification of right toe(s) involvement
- ✓Documentation of previous trauma to right toe(s)
- ✓Clinical or radiological evidence of bone necrosis in toe bones
- ✓Number and specific toes affected when documented
- ✓Assessment of gait impact and balance issues
- ✓Current pain levels and functional limitations
- ✓Treatment history and response to interventions
- ✓Impact on weight-bearing and ambulation patterns
Commonly Confused Codes
- •M87.278 — Osteonecrosis due to previous trauma, left toe(s) (wrong laterality)
- •M87.279 — Osteonecrosis due to previous trauma, unspecified toe(s) (when laterality is documented)
- •M87.274 — Osteonecrosis due to previous trauma, right foot (broader anatomical involvement)
- •M87.377 — Other secondary osteonecrosis, right toe(s) (non-traumatic secondary cause)
- •S92.101A — Fracture of unspecified toe(s), right foot (acute fracture, not osteonecrosis)