M89.649 ICD-10-CM Code: Osteopathy after poliomyelitis, unspecified hand
M89.649 maps to CMS-HCC V28 92. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)
M89.649
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOsteopathy 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.
Buddy Insight
Unspecified hand post-polio osteopathy represents chronic bone changes in hand structures following poliomyelitis without documented laterality, potentially indicating bilateral involvement or incomplete documentation.
CMS-HCC V28
MappedHCC 92
Coefficient HCC 92: 0.479 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 055
Code-level coefficient reference
ESRD/PACE
MappedHCC 39
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for M89.649. Check the code and parent instructions in the Code Book.
Excludes 2
Official- arthropathic psoriasis (L40.5-)Inherited from M00-M99
- certain conditions originating in the perinatal period (P04-P96)Inherited from M00-M99
- certain infectious and parasitic diseases (A00-B99)Inherited from M00-M99
- compartment syndrome (traumatic) (T79.A-)Inherited from M00-M99
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from M00-M99
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from M00-M99
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from M00-M99
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from M00-M99
- neoplasms (C00-D49)Inherited from M00-M99
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from M00-M99
Related Codes
Includes
OfficialNo Includes notes are included in this display for M89.649. Check the code and parent instructions in the Code Book.
Excludes 1
Official- postprocedural osteopathies (M96.-)Inherited from M86-M90, M89.6
- postpolio syndrome (G14)Inherited from M86-M90, M89.6
Code First
OfficialNo Code First sequencing instructions are included in this display for M89.649. Check the code and parent instructions in the Code Book.
Use Additional
Official- code (B91) to identify previous poliomyelitisInherited from M89.6
Code Also
OfficialNo Code Also instructions are included in this display for M89.649. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is M89.649 an HCC code?
Yes. M89.649 (Osteopathy after poliomyelitis, unspecified hand) maps to HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.479. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: M89.649 is billable and maps to V28 HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- M89.649
- Description
- Osteopathy after poliomyelitis, unspecified hand
- HCC (V28)
- HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- RAF reference coefficient
- 0.479
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work M89.649 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for M89.649
For M89.649, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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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/Severe Soft Tissue Infections/Necrosis (HCC 92) with a source-labeled community, non-dual, aged reference coefficient of 0.479. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Use this code only when documentation does not specify right or left side. For M89.649, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, 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
Commonly Confused Codes
- •G14: Post-polio syndrome involves neurological rather than bone pathology
- •M25.549: Unspecified hand pain is symptomatic only
- •S62.609A: Unspecified hand fracture is acute injury
- •M19.049: Primary hand osteoarthritis is degenerative, not post-infectious
- •M87.849: Other osteonecrosis has different pathophysiology