M85.469
M85.469 — Solitary bone cyst, unspecified tibia and fibula
Billable / specific codeICD-10-CM
M85.469 is a billable, specific ICD-10-CM code for solitary bone cyst, unspecified tibia and fibula. It is valid for submission on a claim.
Risk adjustment
M85.469 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.
Medicare coverage
M85.469 is named in 6 Medicare coverage policies — 0 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
Related codes at this level
Codes that share M85.46. If M85.469 is not quite right, the correct code is usually one of these.
Questions about M85.469
- Is M85.469 a billable ICD-10-CM code?
- Yes. M85.469 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M85.469 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).