M87.837
BillableOther osteonecrosis of right carpus
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.837 an HCC code?
Yes. M87.837 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 M87.837
For M87.837 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 M87.837 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.837 is the ICD-10-CM diagnosis code for other osteonecrosis of right carpus. Death of bone tissue in the right carpal bones (small bones in the wrist) due to causes other than trauma or infection, leading to bone deterioration and potential collapse. M87.837 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, M87.837 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, M87.837 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.
Carpus refers to the wrist bones; ensure this is not confused with carpal tunnel syndrome. Because M87.837 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 M87.837 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Carpus refers to the wrist bones; ensure this is not confused with carpal tunnel syndrome
- •Document which specific carpal bone is affected if available, though the code encompasses all carpal bones
Clinical Significance
Osteonecrosis of the right carpus affects the small bones of the wrist, potentially leading to severe functional impairment and chronic disability. This diagnosis is significant for risk adjustment as it represents a complex condition requiring specialized orthopedic care and potential reconstructive surgery.
Documentation Requirements
- ✓Specific identification of the right carpal bones as the site of osteonecrosis
- ✓Documentation of osteonecrosis from causes other than idiopathic or drug-induced
- ✓Advanced imaging (MRI, CT, bone scan) confirming carpal bone necrosis
- ✓Clinical symptoms including wrist pain, stiffness, and functional limitations
- ✓Exclusion of infectious or traumatic causes as primary etiology
- ✓Assessment of impact on hand function and grip strength
- ✓Documentation of any underlying conditions or risk factors
- ✓Provider evaluation of treatment options including potential surgical intervention