M89.649
BillableOsteopathy after poliomyelitis, unspecified hand
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M89.649 an HCC code?
Yes. M89.649 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 M89.649
For M89.649 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 M89.649 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M89.649 is the ICD-10-CM diagnosis code for osteopathy after poliomyelitis, unspecified hand. Bone disease that develops as a long-term consequence of polio infection, affecting the hand when the specific side is not documented. M89.649 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, M89.649 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, M89.649 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 only when documentation does not specify right or left side. Because M89.649 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 M89.649 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when documentation does not specify right or left side
- •Query provider if laterality can be determined from clinical context or imaging reports
Clinical Significance
Unspecified hand post-polio osteopathy represents chronic bone changes in hand structures following poliomyelitis without documented laterality, potentially indicating bilateral involvement or incomplete documentation. This significantly affects hand function and independence.
Documentation Requirements
- ✓Documented history of previous poliomyelitis infection
- ✓Documentation of hand osteopathy without side specification
- ✓Assessment for bilateral hand involvement
- ✓Imaging studies showing post-polio bone changes
- ✓Bilateral hand functional evaluation if applicable
- ✓Grip strength and dexterity assessment
- ✓Activities of daily living impact evaluation
- ✓Hand therapy needs and adaptive equipment recommendations