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M90.532 ICD-10-CM Code: Osteonecrosis in diseases classified elsewhere, left forearm

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

M90.532

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Osteonecrosis in diseases classified elsewhere, left forearm

Death of bone tissue in the left forearm caused by another disease or condition affecting the body.

Buddy the Bee presenting code insight

Buddy Insight

This diagnosis represents secondary osteonecrosis affecting the left forearm, indicating bone death caused by an underlying disease process requiring active management.

CMS-HCC V28

HCC 92

RAF 0.479

CMS-HCC V24

HCC 39

RAF 0.401

ACA/HHS

HCC 55

Varies by metal level

ESRD/PACE

HCC 39

RAF 0.092

RXHCC

HCC 80

RAF 0.204

Code Book Path

Official
M90.5Osteonecrosis in diseases classified elsewhere
M90.53Osteonecrosis in diseases classified elsewhere, forearm
M90.532Osteonecrosis in diseases classified elsewhere, left forearm

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M90.532 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M90.532 in this effective period.

Related Child Codes

Official
M90.531Osteonecrosis in diseases classified elsewhere, right forearm
M90.539Osteonecrosis in diseases classified elsewhere, unspecified forearm

Includes

Official

ICD-10-CM does not list Includes notes for M90.532 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M90.532 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M90.532 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M90.532 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M90.532 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Clear identification of the specific underlying disease causing the osteonecrosis
Documentation of left forearm as the affected anatomical location
Evidence of bone necrosis through imaging studies (MRI, CT, or bone scan)
Clinical correlation between the primary disease and secondary osteonecrosis

MEAT Support

HCC Buddy guidance
Clear identification of the specific underlying disease causing the osteonecrosis
Documentation of left forearm as the affected anatomical location
Evidence of bone necrosis through imaging studies (MRI, CT, or bone scan)
Clinical correlation between the primary disease and secondary osteonecrosis

Audit Caution

HCC Buddy guidance
Failing to verify the underlying disease is documented and coded separately as required
Coding when documentation only mentions 'possible' or 'suspected' osteonecrosis
Missing the laterality specification and defaulting to unspecified codes
Confusing secondary osteonecrosis with primary avascular necrosis conditions

Common Mistakes

HCC Buddy guidance
M87.032 — Primary osteonecrosis of left forearm, not secondary to another disease
M90.539 — Same condition but unspecified forearm location rather than specifically left
M86.132 — Chronic osteomyelitis with draining sinus of left forearm, which is infection rather than necrosis
S52.92XA — Fracture of left forearm, which is acute trauma rather than disease-related bone death

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 M90.532 an HCC code?

Yes. M90.532 (Osteonecrosis in diseases classified elsewhere, left forearm) maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24), with a community non-dual aged RAF of 0.479. It is billable for payment year 2026.

Coder answer: M90.532 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
M90.532
Description
Osteonecrosis in diseases classified elsewhere, left forearm
HCC (V28)
HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
RAF
0.479
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
0.479
V24HCC 39, Bone/Joint/Muscle Infections/Necrosis
0.401
ESRDHCC 39, Bone/Joint/Muscle Infections/Necrosis
0.092
RxHCCHCC 80, Bone/Joint/Muscle Infections/Necrosis
0.204

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work M90.532 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for M90.532

For M90.532 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 M90.532 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

M90.532 is the ICD-10-CM diagnosis code for osteonecrosis in diseases classified elsewhere, left forearm. Death of bone tissue in the left forearm caused by another disease or condition affecting the body. M90.532 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, M90.532 maps to Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.479. Under the older CMS-HCC V24 model, M90.532 maps to Bone/Joint/Muscle Infections/Necrosis (HCC 39) with a community, non-dual, aged base RAF weight of 0.401. 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.

Document which forearm bone is affected (radius, ulna, or both) for clinical clarity. Because M90.532 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 M90.532 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document which forearm bone is affected (radius, ulna, or both) for clinical clarity
  • Requires an underlying condition code to explain the etiology of the osteonecrosis

Clinical Significance

This diagnosis represents secondary osteonecrosis affecting the left forearm, indicating bone death caused by an underlying disease process requiring active management. The condition significantly impacts risk adjustment modeling as it reflects complex medical comorbidities and potential functional limitations requiring ongoing specialized care.

Documentation Requirements

  • Clear identification of the specific underlying disease causing the osteonecrosis
  • Documentation of left forearm as the affected anatomical location
  • Evidence of bone necrosis through imaging studies (MRI, CT, or bone scan)
  • Clinical correlation between the primary disease and secondary osteonecrosis
  • Current treatment plan or management approach
  • Assessment of functional impact on the patient
  • Provider statement linking osteonecrosis to the classified disease
  • Documentation ruling out primary osteonecrosis or trauma-related causes

Commonly Confused Codes

  • M87.032: Primary osteonecrosis of left forearm, not secondary to another disease
  • M90.539: Same condition but unspecified forearm location rather than specifically left
  • M86.132: Chronic osteomyelitis with draining sinus of left forearm, which is infection rather than necrosis
  • S52.92XA: Fracture of left forearm, which is acute trauma rather than disease-related bone death
  • M25.532: Pain in left forearm, which is symptom-based rather than structural bone pathology

Child Codes

Code Hierarchy

Because M90.532 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

M90.532 maps to CMS-HCC V28 category 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because M90.532 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work M90.532 in HCC Buddy

Open M90.532 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.