M87.352
BillableOther secondary osteonecrosis, left femur
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.352 an HCC code?
Yes. M87.352 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 M87.352
For M87.352 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 M87.352 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.352 is the ICD-10-CM diagnosis code for other secondary osteonecrosis, left femur. Death of bone tissue in the left thighbone caused by an underlying condition or treatment, often leading to pain, limping, and potential need for surgical intervention. M87.352 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, M87.352 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, M87.352 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 left laterality is clearly documented in the medical record. Because M87.352 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 M87.352 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify left laterality is clearly documented in the medical record
- •Consider documenting the stage and location within the femur (head, neck, shaft) for clinical clarity
Clinical Significance
This diagnosis represents secondary osteonecrosis of the left femur, often involving the femoral head, which can lead to hip joint collapse and require joint replacement. It necessitates aggressive management of the underlying cause and close orthopedic monitoring.
Documentation Requirements
- ✓Documentation of osteonecrosis affecting left femur
- ✓Identification of underlying cause (e.g., corticosteroid use, alcohol abuse, radiation)
- ✓Imaging findings confirming femoral bone necrosis (MRI, X-ray, CT)
- ✓Clinical symptoms such as groin pain, hip pain, or limping
- ✓Specific location within femur (head, neck, shaft)
- ✓Functional limitations and mobility issues
- ✓Duration and progression of condition
- ✓Treatment history including conservative and surgical options
Commonly Confused Codes
- •M87.852 — Other osteonecrosis of left femur (other causes vs secondary)
- •M87.351 — Other secondary osteonecrosis, right femur (different laterality)
- •M87.052 — Idiopathic osteonecrosis of left femur (idiopathic vs secondary)
- •M16.12 — Unilateral primary osteoarthritis, left hip (arthritis vs necrosis)
- •S72.002A — Fracture of unspecified part of neck of left femur (acute fracture vs necrosis)