Is M86.53 a billable ICD-10-CM code?

No. M86.53 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M86.53 sit in the tabular list?

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

What cannot be coded together with M86.53?

M86.53 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M86.53 (M86) and apply to it just the same.

M86.53

M86.53 — Other chronic hematogenous osteomyelitis, radius and ulna

Non-billable headerICD-10-CM

M86.53 is a non-billable header ICD-10-CM code for other chronic hematogenous osteomyelitis, radius and ulna. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above M86.53

These are not written on M86.53, but they bind it: a note on a category applies to every code beneath it. Billing M86.53 with anything listed here is a denial.

Written on M86 — Osteomyelitis

osteomyelitis due to:
echinococcus (B67.2)
gonococcus (A54.43)
salmonella (A02.24)

Excludes2 inherited from the categories above M86.53

Also inherited, and the opposite of Excludes1: these conditions are not part of M86.53, but a patient can have both, so you may code both.

Written on M86 — Osteomyelitis

ostemyelitis of:
orbit (H05.0-)
petrous bone (H70.2-)
vertebra (M46.2-)

Risk adjustment

M86.53 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 history

M86.53 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead M86.53

3 child codes. Green means billable.

Related codes at this level

Codes that share M86.5. If M86.53 is not quite right, the correct code is usually one of these.

Questions about M86.53

Is M86.53 a billable ICD-10-CM code?: No. M86.53 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M86.53 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other osteopathies (M86-M90).
What cannot be coded together with M86.53?: M86.53 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M86.53 (M86) and apply to it just the same.