M86.00 — Acute hematogenous osteomyelitis, unspecified site

BillableUnspecifiedCC

Is M86.00 billable?

Yes, but M86.00 will trip a Medicare edit. M86.00 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists M86.00 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.

More specific alternatives

M86.00 at a glance

Code	M86.00
Description	Acute hematogenous osteomyelitis, unspecified site
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to M86.00?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M86.00 directly.

Unspecified — a laterality-specific code exists — MCE edit 20

A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.

Which MS-DRGs does M86.00 group to?

M86.00 sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

456Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with MCCsurgical
457Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection with CCsurgical
458Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, or Infection without CC/MCCsurgical

As a secondary diagnosis, M86.00 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is M86.00 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to M86.00. They show the wording a clinician may have documented, which often differs from the Tabular description.

Osteomyelitis › acute › hematogenous (general) (infective) (localized) (neonatal) (purulent) (septic) (staphylococcal) (streptococcal) (suppurative) (with periostitis)

Excludes1 — never code together — inherited from M86-M90

The conditions below can never be reported together with M86.00 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

postprocedural osteopathies (M96.-)

Excludes1 — never code together — inherited from M86

The conditions below can never be reported together with M86.00 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

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

Use additional code — inherited from M86

Report an additional code alongside M86.00 to fully describe the condition. M86.00 is sequenced first.

code (B95-B97) to identify infectious agent
code to identify major osseous defect, if applicable (M89.7-)

Excludes2 — not included here — inherited from Chapter 13

The conditions below are not part of M86.00, but a patient may have both at the same time. When documentation supports it, M86.00 and the excluded code may both be reported.

arthropathic psoriasis (L40.5-)
certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
compartment syndrome (traumatic) (T79.A-)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Excludes2 — not included here — inherited from M86