M72.6 — Necrotizing fasciitis
M72.6 is a billable, specific ICD-10-CM code for necrotizing fasciitis. It is valid for submission on a claim.
Other codes that can never be billed with M72.6
These codes carry an Excludes1 note pointing at M72.6. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M72.6 alone.
- M72.8Other fibroblastic disorders
Risk adjustment
M72.6 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis0.479 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
M72.6 is named in 10 Medicare coverage policies — 4 listing it as supporting medical necessity, and 6 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
How M72.6 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M72.6.
- Fasciitis›necrotizing
- Fasciitis›infective›necrotizing
Related codes at this level
Codes that share M72. If M72.6 is not quite right, the correct code is usually one of these.
Questions about M72.6
- Is M72.6 a billable ICD-10-CM code?
- Yes. M72.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M72.6 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other soft tissue disorders (M70-M79).