Question 1

What is ICD-10 code M93.872?

Accepted Answer

M93.872 is the ICD-10-CM diagnosis code for other specified osteochondropathies, left ankle and foot. A disease affecting the bone and cartilage in the left ankle and foot area, where the specific type is documented but doesn't fit standard categories. M93.872 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).

M93.872 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.

Confirm left-sided involvement is explicitly stated in clinical documentation.

Question 2

Is M93.872 an HCC code?

Accepted Answer

No. M93.872 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 M93.872 billable?

Accepted Answer

Yes. M93.872 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. M93.872 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

What is the V28 vs V24 difference for M93.872?

Accepted Answer

M93.872 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 model rewards M93.872 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting M93.872?

Accepted Answer

Confirm left-sided involvement is explicitly stated in clinical documentation This code is more specific than the unspecified ankle/foot code (M93.879)

M93.872

Is M93.872 an HCC code?

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Code Hierarchy

Open M93.872 in the Interactive Encoder