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ICD-10/M86.49

M86.49 ICD-10-CM Code: Chronic osteomyelitis with draining sinus, multiple sites

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0 (FY2026), Appendix B.

  • MS-DRG 456 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC (MDC 08)
  • MS-DRG 457 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC (MDC 08)
  • MS-DRG 458 — SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC (MDC 08)
  • MS-DRG 539 — OSTEOMYELITIS WITH MCC (MDC 08)
  • MS-DRG 540 — OSTEOMYELITIS WITH CC (MDC 08)
  • MS-DRG 541 — OSTEOMYELITIS WITHOUT CC/MCC (MDC 08)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis

Other models: CMS-HCC V22 HCC 39

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Code Set: Valid FY2026 and FY2027. FY2026 took effect October 1, 2025.

Official Registry Overview & Definition

Chronic osteomyelitis with draining sinus, multiple sites is a billable ICD-10-CM diagnosis code (M86.49).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for M86.49 in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions that can never be reported with this code; the two are mutually exclusive.

  • osteomyelitis due to:
  • echinococcus (B67.2)
  • gonococcus (A54.43)
  • salmonella (A02.24)
  • postprocedural osteopathies (M96.-)

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

  • ostemyelitis of:
  • orbit (H05.0-)
  • petrous bone (H70.2-)
  • vertebra (M46.2-)

Use Additional Code

Supplementary codes the tabular list directs you to add.

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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M86.49 in its code family, with their registry titles.

  • M86.47 — Chronic osteomyelitis with draining sinus, ankle and foot
  • M86.471 — Chronic osteomyelitis with draining sinus, right ankle and foot
  • M86.472 — Chronic osteomyelitis with draining sinus, left ankle and foot
  • M86.479 — Chronic osteomyelitis with draining sinus, unspecified ankle and foot
  • M86.48 — Chronic osteomyelitis with draining sinus, other site
  • M86.5 — Other chronic hematogenous osteomyelitis
  • M86.50 — Other chronic hematogenous osteomyelitis, unspecified site
  • M86.51 — Other chronic hematogenous osteomyelitis, shoulder
  • M86.511 — Other chronic hematogenous osteomyelitis, right shoulder
  • M86.512 — Other chronic hematogenous osteomyelitis, left shoulder

View all codes in the M86 family

Indexed Clinical Terms (1)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Osteomyelitis (general) (infective) (localized) (neonatal) (purulent) (septic) (staphylococcal) (streptococcal) (suppurative) (with periostitis), chronic (or old), with draining sinus, multiple sites