M89.711 ICD-10-CM Code: Major osseous defect, right shoulder region
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other osteopathies (M86-M90)
M89.711
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceMajor osseous defect, right shoulder region
A significant loss or defect in bone structure affecting the right shoulder region, which may impact shoulder function and stability.
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
Inclusion Terms
Official- Major osseous defect clavicle or scapula
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M89.711 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M89.711 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M89.711 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M89.711 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M89.711 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M89.711 in this effective period.
Buddy Documentation Tip
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 M89.711 an HCC code?
No. M89.711 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- M89.711
- Description
- Major osseous defect, right shoulder region
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
M89.711 is the ICD-10-CM diagnosis code for major osseous defect, right shoulder region. A significant loss or defect in bone structure affecting the right shoulder region, which may impact shoulder function and stability. M89.711 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).
M89.711 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Specify laterality (right) in documentation; if the defect involves multiple shoulder structures, consider if additional codes are needed for clarity.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M89.711 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify laterality (right) in documentation; if the defect involves multiple shoulder structures, consider if additional codes are needed for clarity.
- •Document the etiology (post-traumatic, post-surgical, or pathological) to provide complete clinical context for treatment decisions.