M87.836 ICD-10-CM Code: Other osteonecrosis of unspecified ulna
M87.836 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)
M87.836
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther osteonecrosis of unspecified ulna
Death of bone tissue in the ulna (smaller forearm bone) when the specific side (left or right) is not documented or is unclear.
Buddy Insight
Unspecified ulna osteonecrosis represents a chronic bone condition with potential for significant functional disability and ongoing care requirements.
CMS-HCC V28
MappedHCC 92
RAF 0.479
CMS-HCC V24
MappedHCC 39
RAF 0.401
ACA/HHS
MappedHCC 55
Varies by metal level
ESRD/PACE
MappedHCC 39
RAF 0.092
RXHCC
MappedHCC 80
RAF 0.204
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M87.836 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M87.836 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M87.836 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M87.836 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M87.836 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M87.836 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M87.836 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 M87.836 an HCC code?
Yes. M87.836 (Other osteonecrosis of unspecified ulna) 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: M87.836 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
- M87.836
- Description
- Other osteonecrosis of unspecified ulna
- HCC (V28)
- HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- RAF
- 0.479
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 M87.836 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for M87.836
For M87.836 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 M87.836 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
M87.836 is the ICD-10-CM diagnosis code for other osteonecrosis of unspecified ulna. Death of bone tissue in the ulna (smaller forearm bone) when the specific side (left or right) is not documented or is unclear. M87.836 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, M87.836 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, M87.836 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.
This is a default code when laterality is not specified; attempt to clarify with provider documentation. Because M87.836 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 M87.836 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a default code when laterality is not specified; attempt to clarify with provider documentation
- •Check if bilateral osteonecrosis is present, which would require separate codes for each side
Clinical Significance
Unspecified ulna osteonecrosis represents a chronic bone condition with potential for significant functional disability and ongoing care requirements. This diagnosis is important for risk adjustment as it indicates complex orthopedic management needs and the potential for progressive bone deterioration.
Documentation Requirements
- ✓Documentation of osteonecrosis affecting the ulna bone
- ✓Specification that the condition is from causes other than idiopathic or traumatic
- ✓Evidence that laterality (right or left) is not specified or cannot be determined
- ✓Imaging studies confirming bone necrosis in the ulna
- ✓Clinical presentation including forearm or elbow pain and functional impairment
- ✓Exclusion of infectious or drug-induced causes
- ✓Assessment of impact on arm function and quality of life
- ✓Provider documentation of monitoring and treatment plans
Commonly Confused Codes
- •M87.036: Idiopathic aseptic necrosis of unspecified ulna - specifically idiopathic etiology
- •M87.834/M87.835: Other osteonecrosis of right/left ulna - when laterality is actually documented
- •M86.839: Other osteomyelitis, unspecified ulna - infectious bone disease rather than necrosis
- •S52.609A: Unspecified fracture of upper end of unspecified ulna - acute trauma rather than chronic condition
- •M25.529: Pain in unspecified elbow - symptom code rather than specific bone pathology