M86.4 — Chronic osteomyelitis with draining sinus
Is M86.4 billable?
No — M86.4 is a non-billable header code. M86.4 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 24 billable codes beneath M86.4.
Billable codes under this header
- M86.40Chronic osteomyelitis with draining sinus, unspecified site
- M86.48Chronic osteomyelitis with draining sinus, other site
- M86.49Chronic osteomyelitis with draining sinus, multiple sites
- M86.411Chronic osteomyelitis with draining sinus, right shoulder
- M86.412Chronic osteomyelitis with draining sinus, left shoulder
- M86.419Chronic osteomyelitis with draining sinus, unspecified shoulder
- M86.421Chronic osteomyelitis with draining sinus, right humerus
- M86.422Chronic osteomyelitis with draining sinus, left humerus
- M86.429Chronic osteomyelitis with draining sinus, unspecified humerus
- M86.431Chronic osteomyelitis with draining sinus, right radius and ulna
- M86.432Chronic osteomyelitis with draining sinus, left radius and ulna
- M86.439Chronic osteomyelitis with draining sinus, unspecified radius and ulna
- M86.441Chronic osteomyelitis with draining sinus, right hand
- M86.442Chronic osteomyelitis with draining sinus, left hand
- M86.449Chronic osteomyelitis with draining sinus, unspecified hand
- M86.451Chronic osteomyelitis with draining sinus, right femur
- M86.452Chronic osteomyelitis with draining sinus, left femur
- M86.459Chronic osteomyelitis with draining sinus, unspecified femur
- M86.461Chronic osteomyelitis with draining sinus, right tibia and fibula
- M86.462Chronic osteomyelitis with draining sinus, left tibia and fibula
- M86.469Chronic osteomyelitis with draining sinus, unspecified tibia and fibula
- M86.471Chronic osteomyelitis with draining sinus, right ankle and foot
- M86.472Chronic osteomyelitis with draining sinus, left ankle and foot
- M86.479Chronic osteomyelitis with draining sinus, unspecified ankle and foot
M86.4 at a glance
| Code | M86.4 |
|---|---|
| Description | Chronic osteomyelitis with draining sinus |
| Billable | No — header code |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Excludes1 — never code together — inherited from M86-M90
The conditions below can never be reported together with M86.4 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 M86.4 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 M86.4 to fully describe the condition. M86.4 is sequenced first.
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M86.4, but a patient may have both at the same time. When documentation supports it, M86.4 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 M86.4, but a patient may have both at the same time. When documentation supports it, M86.4 and the excluded code may both be reported.
What codes fall under M86.4? (10)
- M86.40Chronic osteomyelitis with draining sinus, unspecified site
- M86.41Chronic osteomyelitis with draining sinus, shouldernot billable
- M86.42Chronic osteomyelitis with draining sinus, humerusnot billable
- M86.43Chronic osteomyelitis with draining sinus, radius and ulnanot billable
- M86.44Chronic osteomyelitis with draining sinus, handnot billable
- M86.45Chronic osteomyelitis with draining sinus, femurnot billable
- M86.46Chronic osteomyelitis with draining sinus, tibia and fibulanot billable
- M86.47Chronic osteomyelitis with draining sinus, ankle and footnot billable
- M86.48Chronic osteomyelitis with draining sinus, other site
- M86.49Chronic osteomyelitis with draining sinus, multiple sites
How long has M86.4 existed?
M86.4 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.
What other codes are in the M86 family? (8)
- M86.0Acute hematogenous osteomyelitisnot billable
- M86.1Other acute osteomyelitisnot billable
- M86.2Subacute osteomyelitisnot billable
- M86.3Chronic multifocal osteomyelitisnot billable
- M86.5Other chronic hematogenous osteomyelitisnot billable
- M86.6Other chronic osteomyelitisnot billable
- M86.8Other osteomyelitisnot billable
- M86.9Osteomyelitis, unspecified