Question 1

What is ICD-10 code N86?

Accepted Answer

N86 is the ICD-10-CM diagnosis code for erosion and ectropion of cervix uteri. Damage or turning outward of the cervical tissue, often causing irritation, bleeding, or discharge. N86 sits in the ICD-10-CM chapter for diseases of the genitourinary system (n00-n99), within the section covering noninflammatory disorders of female genital tract (n80-n98).

N86 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.

Document whether this is erosion (loss of surface tissue) or ectropion (eversion of tissue) as they may have different etiologies.

Question 2

Is N86 an HCC code?

Accepted Answer

No. N86 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 N86 billable?

Accepted Answer

Yes. N86 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. N86 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 N86?

Accepted Answer

N86 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 N86 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 N86?

Accepted Answer

Document whether this is erosion (loss of surface tissue) or ectropion (eversion of tissue) as they may have different etiologies Note any associated symptoms such as postcoital bleeding or abnormal discharge for complete clinical documentation

N86

Is N86 an HCC code?

What This Code Means

Coding Tips

Excludes 1 — Do NOT code together

Code Hierarchy

Open N86 in the Interactive Encoder