Is M86.59 a billable ICD-10-CM code?

Yes. M86.59 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M86.59 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 M86.59?

M86.59 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 M86.59 (M86) and apply to it just the same.

M86.59

M86.59 — Other chronic hematogenous osteomyelitis, multiple sites

Billable / specific codeICD-10-CM

M86.59 is a billable, specific ICD-10-CM code for other chronic hematogenous osteomyelitis, multiple sites. It is valid for submission on a claim.

Excludes1 inherited from the categories above M86.59

These are not written on M86.59, but they bind it: a note on a category applies to every code beneath it. Billing M86.59 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 M86.59

Also inherited, and the opposite of Excludes1: these conditions are not part of M86.59, 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

M86.59 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

M86.59 is named in 10 Medicare coverage policies — 3 listing it as supporting medical necessity, and 7 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
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

How M86.59 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 M86.59.

Osteomyelitis›chronic›hematogenous NEC›multiple sites

Code history

M86.59 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share M86.5. If M86.59 is not quite right, the correct code is usually one of these.

Questions about M86.59

Is M86.59 a billable ICD-10-CM code?: Yes. M86.59 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M86.59 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 M86.59?: M86.59 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 M86.59 (M86) and apply to it just the same.