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M87.29 ICD-10-CM Code: Osteonecrosis due to previous trauma, multiple sites

M87.29 maps to CMS-HCC V28 92 (RAF 0.479). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools

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

M87.29

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

Osteonecrosis due to previous trauma, multiple sites

Death of bone tissue in multiple different body locations caused by previous injuries or trauma.

Buddy the Bee presenting code insight

Buddy Insight

Multiple site post-traumatic osteonecrosis represents extensive bone pathology affecting multiple anatomical locations, indicating severe complications from trauma with significant impact on overall function and mobility.

CMS-HCC V28

HCC 92

RAF 0.479

CMS-HCC V24

HCC 39

RAF 0.401

ACA/HHS

HCC 55

Varies by metal level

ESRD/PACE

HCC 39

RAF 0.092

RXHCC

HCC 80

RAF 0.204

Code Book Path

Official
M87Osteonecrosis
M87.2Osteonecrosis due to previous trauma
M87.29Osteonecrosis due to previous trauma, multiple sites

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M87.29 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M87.29 in this effective period.

Related Child Codes

Official
M87.20Osteonecrosis due to previous trauma, unspecified bone
M87.21Osteonecrosis due to previous trauma, shoulder
M87.22Osteonecrosis due to previous trauma, humerus
M87.23Osteonecrosis due to previous trauma of radius, ulna and carpus
M87.24Osteonecrosis due to previous trauma, hand and fingers

Includes

Official

ICD-10-CM does not list Includes notes for M87.29 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M87.29 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M87.29 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M87.29 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M87.29 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of multiple anatomical sites affected
Clear history of trauma affecting multiple areas or systemic factors
Evidence of bone necrosis in at least two distinct anatomical locations
Specific identification of affected sites when documented

MEAT Support

HCC Buddy guidance
Documentation of multiple anatomical sites affected
Clear history of trauma affecting multiple areas or systemic factors
Evidence of bone necrosis in at least two distinct anatomical locations
Specific identification of affected sites when documented

Audit Caution

HCC Buddy guidance
Using single site codes when multiple locations are clearly documented
Failing to establish traumatic etiology versus other secondary causes
Confusing with other site code when multiple specific locations are involved
Using unspecified codes when multiple sites are documented

Common Mistakes

HCC Buddy guidance
M87.28 — Osteonecrosis due to previous trauma, other site (single unusual site)
M87.389 — Other secondary osteonecrosis, multiple sites (non-traumatic secondary cause)
M87.80 — Other osteonecrosis, unspecified bone (single unspecified location)
M87.9 — Osteonecrosis, unspecified (when etiology and sites are unclear)

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 M87.29 an HCC code?

Yes. M87.29 (Osteonecrosis due to previous trauma, multiple sites) 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: M87.29 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
M87.29
Description
Osteonecrosis due to previous trauma, multiple sites
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 M87.29 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for M87.29

For M87.29 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 M87.29 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

M87.29 is the ICD-10-CM diagnosis code for osteonecrosis due to previous trauma, multiple sites. Death of bone tissue in multiple different body locations caused by previous injuries or trauma. M87.29 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, M87.29 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, M87.29 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.

Use only when osteonecrosis is documented in two or more separate anatomical sites. Because M87.29 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 M87.29 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use only when osteonecrosis is documented in two or more separate anatomical sites
  • Consider using additional codes if specific sites need individual documentation for clinical clarity

Clinical Significance

Multiple site post-traumatic osteonecrosis represents extensive bone pathology affecting multiple anatomical locations, indicating severe complications from trauma with significant impact on overall function and mobility. This condition typically requires comprehensive multidisciplinary management and may result in substantial disability.

Documentation Requirements

  • Documentation of multiple anatomical sites affected
  • Clear history of trauma affecting multiple areas or systemic factors
  • Evidence of bone necrosis in at least two distinct anatomical locations
  • Specific identification of affected sites when documented
  • Assessment of cumulative functional impact
  • Current pain levels and mobility limitations across sites
  • Comprehensive treatment planning and specialist involvement
  • Impact on patient's overall independence and quality of life

Commonly Confused Codes

  • M87.28: Osteonecrosis due to previous trauma, other site (single unusual site)
  • M87.389: Other secondary osteonecrosis, multiple sites (non-traumatic secondary cause)
  • M87.80: Other osteonecrosis, unspecified bone (single unspecified location)
  • M87.9: Osteonecrosis, unspecified (when etiology and sites are unclear)
  • M89.8X9: Other specified disorders of bone, multiple sites (different bone pathology)

Child Codes

Code Hierarchy

Because M87.29 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.

M87.29 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. Because M87.29 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work M87.29 in HCC Buddy

Open M87.29 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.