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M89.369

Billable

Hypertrophy of bone, unspecified tibia and fibula

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is M89.369 an HCC code?

No. M89.369 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

M89.369 is the ICD-10-CM diagnosis code for hypertrophy of bone, unspecified tibia and fibula. Abnormal thickening and enlargement of the bones in the tibia and/or fibula when the specific side is not documented or when both sides are affected. M89.369 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).

M89.369 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Use this code when laterality is unspecified or when documentation does not clearly indicate right or left.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M89.369 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use this code when laterality is unspecified or when documentation does not clearly indicate right or left
  • This is the default code for tibia and fibula hypertrophy when side-specific codes cannot be applied

Code Hierarchy

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