Is M86.42 a billable ICD-10-CM code?

No. M86.42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M86.42 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other osteopathies (M86-M90).

M86.42

M86.42 — Chronic osteomyelitis with draining sinus, humerus

Non-billable headerICD-10-CM

M86.42 is a non-billable header ICD-10-CM code for chronic osteomyelitis with draining sinus, humerus. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

M86.42 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 M86.42

3 child codes. Green means billable.

Related codes at this level

Codes that share M86.4. If M86.42 is not quite right, the correct code is usually one of these.

Questions about M86.42

Is M86.42 a billable ICD-10-CM code?: No. M86.42 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M86.42 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other osteopathies (M86-M90).