M86.49 — Chronic osteomyelitis with draining sinus, multiple sites
M86.49 is a billable, specific ICD-10-CM code for chronic osteomyelitis with draining sinus, multiple sites. It is valid for submission on a claim.
Risk adjustment
M86.49 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
M86.49 is named in 9 Medicare coverage policies — 3 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 M86.49 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 M86.49.
- Osteomyelitis›chronic›with draining sinus›multiple sites
Related codes at this level
Codes that share M86.4. If M86.49 is not quite right, the correct code is usually one of these.
- M86.40Chronic osteomyelitis with draining sinus, unspecified site
- M86.41Chronic osteomyelitis with draining sinus, shoulder
- M86.42Chronic osteomyelitis with draining sinus, humerus
- M86.43Chronic osteomyelitis with draining sinus, radius and ulna
- M86.44Chronic osteomyelitis with draining sinus, hand
- M86.45Chronic osteomyelitis with draining sinus, femur
- M86.46Chronic osteomyelitis with draining sinus, tibia and fibula
- M86.47Chronic osteomyelitis with draining sinus, ankle and foot
- M86.48Chronic osteomyelitis with draining sinus, other site
Questions about M86.49
- Is M86.49 a billable ICD-10-CM code?
- Yes. M86.49 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M86.49 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other osteopathies (M86-M90).