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ICD-10-CM M86.269: Subacute osteomyelitis, unspecified tibia and fibula

M86.269 is the billable ICD-10-CM code for subacute osteomyelitis, unspecified tibia and fibula, in category M86 (Osteomyelitis) of the Other osteopathies section. As a principal diagnosis it groups to MS-DRG 400 Knee Procedures with Principal Diagnosis of Infection, MS-DRG 539 Osteomyelitis with MCC, MS-DRG 540 Osteomyelitis with CC (MDC 08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue). It maps to HCC 92 (Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 68 principal diagnoses.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
M86.269
billable FY2027 ICD-10-CM code
Category
M86 Osteomyelitis
Chapter
13: Diseases of the musculoskeletal system and connective tissue (M00-M99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 92
POA reporting
Required

Tabular list notes for M86.269

The tabular list has no notes on M86.269 itself; the notes below apply from its parent headings.

Inherited from M86 (Osteomyelitis)

Excludes1 (never coded together)
  • osteomyelitis due to:
  • echinococcus (B67.2)
  • gonococcus (A54.43)
  • salmonella (A02.24)
Excludes2 (not part of this condition, may be coded together)
  • ostemyelitis of:
  • orbit (H05.0-)
  • petrous bone (H70.2-)
  • vertebra (M46.2-)
Use additional code
  • code (B95-B97) to identify infectious agent
  • code to identify major osseous defect, if applicable (M89.7-)

MS-DRG grouping when M86.269 is the principal diagnosis

MS-DRG v44 groups for M86.269 as principal diagnosis
MDCMS-DRGs
08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue400539540541

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for M86.269 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, M86.269 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 68 codes in its exclusion list. Check M86.269 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.
  • Medicare Code Editor: unspecified code where a laterality-specific code exists.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, M86.269 maps to HCC 92 (Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis). The HCC lookup shows the RAF weight and the hierarchy.

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Frequently asked questions

What does ICD-10-CM M86.269 mean?

M86.269 means subacute osteomyelitis, unspecified tibia and fibula. It is one of 25 billable codes under M86, osteomyelitis.

Which MS-DRG does M86.269 group to?

As the principal diagnosis, M86.269 groups to MS-DRG 400 Knee Procedures with Principal Diagnosis of Infection, MS-DRG 539 Osteomyelitis with MCC, MS-DRG 540 Osteomyelitis with CC (MDC 08 MDC 08: Diseases and Disorders of the Musculoskeletal System and Connective Tissue) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does M86.269 map to an HCC?

Yes: HCC 92, Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis, in the PY2027 CMS-HCC V28 mapping.

Is M86.269 a CC or MCC?

M86.269 is a CC under MS-DRG v44; 68 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.