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M89.7 ICD-10-CM Code: Major osseous defect

ICD-10-CM Code View

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)

M89.7

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Major osseous defect

Major osseous defect

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
M89Other disorders of bone
M89.7Major osseous defect

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M89.7 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M89.7 in this effective period.

Related Child Codes

Official
M89.70Major osseous defect, unspecified site
M89.71Major osseous defect, shoulder region
M89.72Major osseous defect, humerus
M89.73Major osseous defect, forearm
M89.74Major osseous defect, hand

Includes

Official

ICD-10-CM does not list Includes notes for M89.7 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M89.7 in this effective period.

Code First

Official
  • underlying disease, if known, such as:
  • aseptic necrosis of bone (M87.-)
  • malignant neoplasm of bone (C40.-)
  • osteolysis (M89.5-)
  • osteomyelitis (M86.-)

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M89.7 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M89.7 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

M89.7 is the ICD-10-CM diagnosis code for major osseous defect. M89.7 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).

Header codes like M89.7 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at M89.7's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M89.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Code First

  • underlying disease, if known, such as:
  • aseptic necrosis of bone (M87.-)
  • malignant neoplasm of bone (C40.-)
  • osteolysis (M89.5-)
  • osteomyelitis (M86.-)
  • osteonecrosis (M87.-)
  • osteoporosis (M80.-, M81.-)
  • periprosthetic osteolysis (T84.05-)

Child Codes

Code Hierarchy

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