M89.78 — Major osseous defect, other site
M89.78 is a billable, specific ICD-10-CM code for major osseous defect, other site. It is valid for submission on a claim.
Risk adjustment
M89.78 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.
Medicare coverage
M89.78 is named in 8 Medicare coverage policies — 2 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 M89.78 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 M89.78.
- Defect, defective›major osseous›specified NEC
- Defect, defective›osseous, major›specified NEC
Related codes at this level
Codes that share M89.7. If M89.78 is not quite right, the correct code is usually one of these.
- M89.70Major osseous defect, unspecified site
- M89.71Major osseous defect, shoulder region
- M89.72Major osseous defect, humerus
- M89.73Major osseous defect, forearm
- M89.74Major osseous defect, hand
- M89.75Major osseous defect, pelvic region and thigh
- M89.76Major osseous defect, lower leg
- M89.77Major osseous defect, ankle and foot
- M89.79Major osseous defect, multiple sites
Questions about M89.78
- Is M89.78 a billable ICD-10-CM code?
- Yes. M89.78 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M89.78 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other osteopathies (M86-M90).