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M87.342

Billable

Other secondary osteonecrosis, left hand

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is M87.342 an HCC code?

Yes. M87.342 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

V28HCC 92Bone/Joint/Muscle Infections/Necrosis
0.209
V24HCC 39Bone/Joint/Muscle Infections/Necrosis
0.482
ESRDHCC 39Bone/Joint/Muscle Infections/Necrosis
0.000
RxHCCHCC 80Bone/Joint/Muscle Infections/Necrosis
0.000

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 M87.342

For M87.342 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 M87.342 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

M87.342 is the ICD-10-CM diagnosis code for other secondary osteonecrosis, left hand. Death of bone tissue in the left hand caused by an underlying condition or injury, affecting the hand structure and function. M87.342 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, M87.342 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, M87.342 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.

Confirm left laterality is documented; this code represents the entire left hand involvement. Because M87.342 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 M87.342 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Confirm left laterality is documented; this code represents the entire left hand involvement
  • If only specific fingers or bones are affected, more specific codes may be more appropriate

Clinical Significance

Left hand secondary osteonecrosis represents bone death from identifiable non-traumatic causes affecting the dominant hand in most patients. This condition severely impacts hand function, grip strength, and dexterity, requiring comprehensive management to preserve fine motor capabilities.

Documentation Requirements

  • Clear documentation of secondary cause of osteonecrosis
  • Radiological evidence of bone necrosis in left hand
  • Clinical assessment demonstrating left hand impairment
  • History of predisposing conditions or medications
  • Exclusion of trauma and idiopathic causes
  • Documentation of functional impact on activities of daily living
  • Provider correlation of secondary etiology
  • Evidence of compromised bone blood supply in hand

Commonly Confused Codes

  • M87.042 — Idiopathic osteonecrosis of left hand (spontaneous)
  • M87.242 — Osteonecrosis due to previous trauma of left hand (traumatic)
  • S62.92XA — Unspecified fracture of unspecified part of left wrist and hand (acute)
  • M86.042 — Acute hematogenous osteomyelitis of left hand (infection)
  • M25.542 — Pain in joints of left hand (symptom code)

Code Hierarchy

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