M89.631
BillableOsteopathy after poliomyelitis, right forearm
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M89.631 an HCC code?
Yes. M89.631 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 M89.631
For M89.631 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 M89.631 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M89.631 is the ICD-10-CM diagnosis code for osteopathy after poliomyelitis, right forearm. Bone disease that develops as a long-term consequence of polio infection, affecting the right forearm. M89.631 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, M89.631 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, M89.631 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.
This code is used for post-polio sequelae affecting bone structure; ensure polio history is documented. Because M89.631 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 M89.631 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is used for post-polio sequelae affecting bone structure; ensure polio history is documented
- •Verify laterality is clearly documented as right before assigning this code
Clinical Significance
Right forearm post-polio osteopathy represents chronic bone changes in the radius and ulna following poliomyelitis infection, potentially affecting forearm rotation and hand function. This condition requires ongoing orthopedic management as part of comprehensive post-polio care.
Documentation Requirements
- ✓Clear history of previous poliomyelitis infection
- ✓Specific identification of right forearm bone involvement
- ✓Imaging evidence of post-polio osteopathic changes in radius/ulna
- ✓Assessment of forearm rotation and wrist function
- ✓Hand grip strength and dexterity evaluation
- ✓Pain assessment and functional limitations
- ✓Occupational therapy needs and adaptive equipment
- ✓Integration with overall post-polio syndrome management