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M89.71 ICD-10-CM Code: Major osseous defect, shoulder region

M89.71 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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

M89.71

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

Major osseous defect, shoulder region

Major osseous defect, shoulder region

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
M89Other disorders of bone
M89.7Major osseous defect
M89.71Major osseous defect, shoulder region

Inclusion Terms

Official
  • Major osseous defect clavicle or scapula

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M89.71 in this effective period.

Related Child Codes

Official
M89.711Major osseous defect, right shoulder region
M89.712Major osseous defect, left shoulder region
M89.719Major osseous defect, unspecified shoulder region

Includes

Official

ICD-10-CM does not list Includes notes for M89.71 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M89.71 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 M89.71 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M89.71 in this effective period.

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 →

Code
M89.71
Description
Major osseous defect, shoulder region
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

M89.71 is the ICD-10-CM diagnosis code for major osseous defect, shoulder region. M89.71 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 M89.71 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 M89.71'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 M89.71 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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