Question 1

What is ICD-10 code M89.022?

Accepted Answer

M89.022 is the ICD-10-CM diagnosis code for algoneurodystrophy, left upper arm. Complex regional pain syndrome affecting the left upper arm, causing pain, swelling, and functional impairment in that arm. M89.022 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).

M89.022 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28, V24, ESRD, or RxHCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Confirm left upper arm is the correct anatomical location and laterality from clinical documentation.

Question 2

Is M89.022 an HCC code?

Accepted Answer

No. M89.022 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is M89.022 billable?

Accepted Answer

Yes. M89.022 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M89.022 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does M89.022 map to under V28?

Accepted Answer

M89.022 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What RAF reference is published for M89.022?

Accepted Answer

M89.022 has no separately stated V28 community reference coefficient. Check the current CMS mapping and factor files before using it in any member-score workflow.

Question 6

What is the V28 vs V24 difference for M89.022?

Accepted Answer

M89.022 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards M89.022 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 7

What documentation supports M89.022?

Accepted Answer

Confirm left upper arm is the correct anatomical location and laterality from clinical documentation Upper arm extends from shoulder joint to elbow; do not confuse with forearm or shoulder codes M89.022 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

HCC Buddy Code Card

M89.022

Is M89.022 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work M89.022 in HCC Buddy

M89.022 ICD-10-CM Code: Algoneurodystrophy, left upper arm

HCC Buddy Code Card

M89.022

Is M89.022 an HCC code?

Get the V28 mapping + MEAT cheat sheet

What This Code Means

Coding Tips

Child Codes

Code Hierarchy

Work M89.022 in HCC Buddy