M86.049 — Acute hematogenous osteomyelitis, unspecified hand
Is M86.049 billable?
Yes, but M86.049 will trip a Medicare edit. M86.049 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists M86.049 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
M86.049 at a glance
| Code | M86.049 |
|---|---|
| Description | Acute hematogenous osteomyelitis, unspecified hand |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to M86.049?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M86.049 directly.
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 M86.049 group to?
M86.049 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.
- 539Osteomyelitis with MCCmedical
- 540Osteomyelitis with CCmedical
- 541Osteomyelitis without CC/MCCmedical
As a secondary diagnosis, M86.049 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M86.049 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M86.04, the nearest indexed parent of M86.049. Use them to find the family, then select the specific code.
- Osteomyelitis › acute › hematogenous › carpus (general) (infective) (localized) (neonatal) (purulent) (septic) (staphylococcal) (streptococcal) (suppurative) (with periostitis)
- Osteomyelitis › acute › hematogenous › finger (general) (infective) (localized) (neonatal) (purulent) (septic) (staphylococcal) (streptococcal) (suppurative) (with periostitis)
- Osteomyelitis › acute › hematogenous › metacarpus (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 M86.049 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 M86.049 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from M86
Report an additional code alongside M86.049 to fully describe the condition. M86.049 is sequenced first.
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M86.049, but a patient may have both at the same time. When documentation supports it, M86.049 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
The conditions below are not part of M86.049, but a patient may have both at the same time. When documentation supports it, M86.049 and the excluded code may both be reported.
How long has M86.049 existed?
M86.049 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.