Is M87.861 a billable ICD-10-CM code?

Yes. M87.861 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M87.861 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 M87.861?

M87.861 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 M87.861 (M87) and apply to it just the same.

M87.861

M87.861 — Other osteonecrosis, right tibia

Billable / specific codeICD-10-CMright

M87.861 is a billable, specific ICD-10-CM code for other osteonecrosis, right tibia. It is valid for submission on a claim.

Excludes1 inherited from the categories above M87.861

These are not written on M87.861, but they bind it: a note on a category applies to every code beneath it. Billing M87.861 with anything listed here is a denial.

Written on M87 — Osteonecrosis

juvenile osteonecrosis (M91-M92)
osteochondropathies (M90-M93)

Risk adjustment

M87.861 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

M87.861 is named in 12 Medicare coverage policies — 5 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

Code history

M87.861 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 M87.86. If M87.861 is not quite right, the correct code is usually one of these.

Questions about M87.861

Is M87.861 a billable ICD-10-CM code?: Yes. M87.861 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M87.861 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 M87.861?: M87.861 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 M87.861 (M87) and apply to it just the same.