Question 1

What is ICD-10 code M92.591?

Accepted Answer

M92.591 is the ICD-10-CM diagnosis code for other juvenile osteochondrosis of tibia and fibula, right leg. A growth plate disorder affecting the shinbone or smaller bone next to it (fibula) in children on the right leg, other than the common tibia tubercle location. M92.591 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering chondropathies (m91-m94).

M92.591 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.

This code captures other sites of osteochondrosis in the tibia/fibula region beyond the tubercle.

Question 2

Is M92.591 an HCC code?

Accepted Answer

No. M92.591 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is M92.591 billable?

Accepted Answer

Yes. M92.591 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M92.591 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does M92.591 map to under V28?

Accepted Answer

M92.591 does not map to a CMS-HCC V28 payment category. Check the current CMS-HCC V28 model file for payment year 2026 rather than an older V24 tip sheet.

Question 5

What does M92.591 pay in RAF?

Accepted Answer

M92.591 has no separately stated V28 community RAF weight. If it is not a V28 payment HCC, it adds nothing to a community RAF score.

Question 6

What is the V28 vs V24 difference for M92.591?

Accepted Answer

M92.591 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards M92.591 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 7

What documentation supports M92.591?

Accepted Answer

This code captures other sites of osteochondrosis in the tibia/fibula region beyond the tubercle Ensure documentation specifies right leg to justify this laterality code M92.591 is not a CMS-HCC payment code, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

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M92.591

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M92.591 ICD-10-CM Code: Other juvenile osteochondrosis of tibia and fibula, right leg

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M92.591

Is M92.591 an HCC code?

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What This Code Means

Coding Tips

Child Codes

Code Hierarchy

M92.591 code history

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