M87.374
BillableOther secondary osteonecrosis, right foot
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.374 an HCC code?
Yes. M87.374 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 M87.374
For M87.374 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 M87.374 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.374 is the ICD-10-CM diagnosis code for other secondary osteonecrosis, right foot. Death of bone tissue in the right foot caused by an underlying condition or treatment such as corticosteroid use, radiation therapy, or previous injury. M87.374 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, M87.374 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, M87.374 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.
Specify which foot bone is affected (metatarsal, tarsal, etc.) in documentation when possible for clarity. Because M87.374 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 M87.374 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify which foot bone is affected (metatarsal, tarsal, etc.) in documentation when possible for clarity
- •Confirm the secondary etiology is documented to differentiate from idiopathic osteonecrosis
Clinical Significance
This diagnosis represents secondary osteonecrosis of the right foot caused by underlying conditions such as corticosteroid use, radiation therapy, or previous injury, which can significantly impact weight-bearing and mobility. It requires management of the causative factor and monitoring for progression.
Documentation Requirements
- ✓Documentation of osteonecrosis affecting right foot bones
- ✓Identification of underlying cause (e.g., corticosteroid use, radiation therapy, diabetes complications)
- ✓Imaging findings confirming foot bone necrosis (MRI, X-ray, CT)
- ✓Clinical symptoms such as foot pain, swelling, or difficulty walking
- ✓Specific foot bones affected (metatarsals, tarsal bones, etc.)
- ✓Functional limitations affecting ambulation
- ✓Duration and progression of condition
- ✓Treatment history including offloading and surgical interventions