M90.541 ICD-10-CM Code: Osteonecrosis in diseases classified elsewhere, right hand
M90.541 maps to CMS-HCC V28 92 (RAF 0.479). Documentation must support MEAT. 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)
M90.541
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOsteonecrosis in diseases classified elsewhere, right hand
Death of bone tissue in the right hand caused by another disease or condition affecting the body.
Buddy Insight
This code represents secondary osteonecrosis specifically affecting the right hand, indicating bone death caused by an underlying classified disease.
CMS-HCC V28
MappedHCC 92
RAF 0.479
CMS-HCC V24
MappedHCC 39
RAF 0.401
ACA/HHS
MappedHCC 55
Varies by metal level
ESRD/PACE
MappedHCC 39
RAF 0.092
RXHCC
MappedHCC 80
RAF 0.204
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M90.541 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M90.541 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M90.541 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M90.541 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M90.541 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M90.541 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M90.541 in this effective period.
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 M90.541 an HCC code?
Yes. M90.541 (Osteonecrosis in diseases classified elsewhere, right hand) 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: M90.541 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
- M90.541
- Description
- Osteonecrosis in diseases classified elsewhere, right hand
- HCC (V28)
- HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- RAF
- 0.479
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 M90.541 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for M90.541
For M90.541 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 M90.541 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
M90.541 is the ICD-10-CM diagnosis code for osteonecrosis in diseases classified elsewhere, right hand. Death of bone tissue in the right hand caused by another disease or condition affecting the body. M90.541 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, M90.541 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, M90.541 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.
Hand includes carpal bones, metacarpals, and phalanges; document which specific bones are affected when possible. Because M90.541 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 M90.541 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Hand includes carpal bones, metacarpals, and phalanges; document which specific bones are affected when possible
- •Always code the underlying disease first, then this manifestation code
Clinical Significance
This code represents secondary osteonecrosis specifically affecting the right hand, indicating bone death caused by an underlying classified disease. The condition requires ongoing medical management and significantly impacts risk adjustment modeling due to associated functional limitations and complex care needs.
Documentation Requirements
- ✓Identification of the underlying disease causing secondary osteonecrosis
- ✓Specific documentation of right hand as affected anatomical site
- ✓Radiological evidence of bone necrosis (MRI, bone scan, CT imaging)
- ✓Clinical correlation establishing disease-to-osteonecrosis relationship
- ✓Current treatment modalities and management approach
- ✓Functional assessment and impact on activities of daily living
- ✓Provider statement confirming secondary nature of osteonecrosis
- ✓Documentation excluding traumatic or primary causes
Commonly Confused Codes
- •M87.041: Primary osteonecrosis of right hand, not secondary to disease
- •M90.549: Same condition affecting unspecified hand rather than specifically right
- •M86.141: Chronic osteomyelitis of right hand, which is infectious rather than necrotic
- •S62.90XA: Unspecified fracture of right hand, which is trauma-related
- •M25.541: Pain in right hand, which is symptomatic rather than structural pathology