Is M85.42 a billable ICD-10-CM code?

No. M85.42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M85.42 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).

M85.42

M85.42 — Solitary bone cyst, humerus

Non-billable headerICD-10-CM

M85.42 is a non-billable header ICD-10-CM code for solitary bone cyst, humerus. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

M85.42 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Code to one of these instead M85.42

3 child codes. Green means billable.

M85.421Solitary bone cyst, right humerus
M85.422Solitary bone cyst, left humerus
M85.429Solitary bone cyst, unspecified humerus

Related codes at this level

Codes that share M85.4. If M85.42 is not quite right, the correct code is usually one of these.

M85.40Solitary bone cyst, unspecified site
M85.41Solitary bone cyst, shoulder
M85.43Solitary bone cyst, ulna and radius
M85.44Solitary bone cyst, hand
M85.45Solitary bone cyst, pelvis
M85.46Solitary bone cyst, tibia and fibula
M85.47Solitary bone cyst, ankle and foot
M85.48Solitary bone cyst, other site

Questions about M85.42

Is M85.42 a billable ICD-10-CM code?: No. M85.42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M85.42 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).