M87.89
BillableOther osteonecrosis, multiple sites
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M87.89 an HCC code?
Yes. M87.89 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 M87.89
For M87.89 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 M87.89 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M87.89 is the ICD-10-CM diagnosis code for other osteonecrosis, multiple sites. Death of bone tissue occurring in multiple locations throughout the body simultaneously. This systemic condition indicates widespread bone involvement and requires comprehensive management. M87.89 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, M87.89 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, M87.89 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.
Use this code when osteonecrosis affects two or more distinct anatomical sites. Because M87.89 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 M87.89 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when osteonecrosis affects two or more distinct anatomical sites
- •Document all affected sites and consider if an underlying systemic cause (e.g., HIV, sickle cell disease) should be coded separately
Clinical Significance
Multiple site osteonecrosis indicates systemic avascular bone death affecting multiple anatomical locations simultaneously, suggesting severe underlying pathophysiology requiring intensive management. This represents the most severe form of osteonecrosis with significant disability potential.
Documentation Requirements
- ✓Documentation of osteonecrosis in multiple distinct anatomical sites
- ✓Comprehensive imaging studies of all affected areas
- ✓Clear exclusion of traumatic, infectious, or radiation-induced causes
- ✓Functional assessment across all affected body regions
- ✓Comprehensive pain evaluation and disability assessment
- ✓Extensive evaluation for underlying systemic conditions
- ✓Coordinated multidisciplinary care plan
- ✓Staging and prognosis documentation for disease progression