M86.129: Other acute osteomyelitis, unspecified humerus
M86.129 is a billable, specific ICD-10-CM code for other acute osteomyelitis, unspecified humerus. It is valid for submission on a claim.
Check M86.129 with the rest of the claim: free scrubberExcludes1 inherited from the categories above M86.129
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above M86.129
Not part of this code, but both may be coded when both are present.
Risk adjustment
M86.129 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
M86.129 is named in 7 Medicare coverage policies: 0 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58883Billing 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
Code history
Unchanged in every release from FY2024 to FY2027.