ICD-10-CM · Other

M86.58

Chronic hematogenous osteomyelitis arising at a skeletal site not captured by the more specific M86.5x site codes — meaning it affects a bone other than shoulder, humerus, radius/ulna, hand, femur, tibia/fibula, or ankle/foot.

Verified May 8, 2026 · 5 sources ↓

Status: Billable
Chapter: 13
Related CPT: 12
Region: Other

Drawn from CDCICD10DataAAPCFindacodeCMS

Documentation tips

What should appear in the chart to support M86.58.

Source · Editorial brief grounded in 5 cited references ↓

Document the specific bone affected by name (e.g., 'chronic hematogenous osteomyelitis of the right clavicle') — 'other site' is a residual category that requires the named site not to match any M86.5x subcategory.
Explicitly state 'chronic' in the diagnosis; if acuity is not documented, query the provider — defaulting to M86.9 (unspecified) loses specificity and may trigger a payer query.
Confirm and document that the infection route is hematogenous; contiguous-spread or post-surgical osteomyelitis at the same site belongs in M86.6x, not M86.5x.
Record the causative organism when known and add a B95–B97 code; absent organism documentation, the M86.58 code stands alone but the claim is vulnerable to medical necessity review.
If imaging reveals a major osseous defect, document its extent and add M89.7- per the ICD-10-CM 'Use additional code' instruction at the M86 category.
Confirm the site is not the orbit (H05.0-), petrous bone (H70.2-), or vertebra (M46.2-) — all are Excludes2 from M86 and require their own code series.

Related CPT procedures

Procedure codes commonly billed with M86.58. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

27070 $826.00

Superficial partial excision of the wing of the ilium, symphysis pubis, or greater trochanter of the femur using craterization or saucerization technique, typically performed for osteomyelitis or bone abscess.

27071 $916.19

Deep partial excision of the iliac wing, symphysis pubis, or greater trochanter of the femur, including techniques such as craterization or saucerization.

23180 $654.99

Partial excision of the clavicle for bone disease, including craterization, saucerization, or diaphysectomy techniques targeting infected or diseased bone tissue.

23182 $640.96

Partial excision of the scapula, removing a portion of the bone while preserving the remaining scapular structure.

24134 $703.09

Surgical removal of dead, sequestered bone from the shaft or distal humerus in the setting of chronic osteomyelitis.

25145 $502.35

Sequestrectomy of the forearm and/or wrist — surgical removal of necrotic or infected bone tissue (sequestrum) from the radius, ulna, or wrist, typically performed for osteomyelitis or bone abscess.

26236 $422.19

Partial excision of the distal phalanx of a finger via craterization, saucerization, or diaphysectomy — typically for osteomyelitis or other localized bone pathology.

21025 $840.03

Surgical removal of infected or necrotic bone from the mandible, performed to treat osteomyelitis or bone abscess unresponsive to conservative management.

21030 $475.96

Surgical removal of a noncancerous tumor or cyst from the upper jaw (maxilla) or cheekbone (zygoma) using enucleation, curettage, or both techniques.

20245 $303.28

Surgical removal of a bone tissue sample from a deep anatomical site — such as the humeral shaft, ischium, or femoral shaft — through an open incision for pathological analysis.

20240 $126.59

Open surgical biopsy of a superficial bone, such as the ilium, sternum, spinous process, rib, or femoral trochanter, performed through a skin incision to obtain tissue for diagnosis.

29125 $79.16

Application of a static (non-articulating) short arm splint extending from the forearm to the hand, used to immobilize the wrist or forearm for injury healing or pre-surgical fracture stabilization.

Common coding pitfalls

The recurring mistakes coders make with M86.58 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Using M86.58 for vertebral osteomyelitis — vertebra is an Excludes2 site under M86; use M46.2- instead.
Assigning M86.58 when the site actually matches a named subcategory (e.g., pelvis coded here correctly, but ankle coded here instead of M86.57x) — always work through the site hierarchy before defaulting to 'other.'
Omitting the B95–B97 organism code when the causative pathogen is documented; the 'Use additional code' instruction at the M86 category level makes this pairing expected by auditors.
Confusing hematogenous route (M86.5-) with contiguous-spread or unspecified chronic infection (M86.6-) — route of infection must be provider-documented, not assumed.
Applying M86.58 to acute presentations; if the provider documents acute onset, drop to M86.0x (acute hematogenous) or query for clarification before coding chronic.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M86.58 captures persistent, bloodstream-seeded bone infection at anatomical locations outside the named site codes in the M86.5x series. Typical 'other site' candidates include the pelvis, clavicle, scapula, ribs, sternum, patella, and small bones of the face or skull (noting the Excludes2 carve-outs for orbit, petrous bone, and vertebra). The infection is classified as hematogenous, meaning the causative organism reached the bone via the bloodstream — not through direct inoculation or contiguous spread from adjacent soft tissue.

To reach M86.58, three documentation elements must be confirmed: (1) the osteomyelitis is chronic rather than acute or subacute, (2) the route of infection is hematogenous, and (3) the affected site is genuinely not one of the seven anatomically coded sites in the M86.5x series. If the site falls under M86.57x (ankle and foot) or any other named subcategory, use that more specific code. M86.59 (multiple sites) applies when hematogenous chronic infection spans several discrete bones simultaneously.

Always check the category-level Excludes1 for M86: osteomyelitis due to echinococcus (B67.2), gonococcus (A54.43), and salmonella (A02.24) must be coded separately from M86. Use an additional code from B95–B97 to identify the infecting organism when documented. If a major osseous defect is present, add M89.7- per the 'Use additional code' instruction at the M86 category level.

Sibling codes

Other billable codes under M86.5 (laterality / anatomic variants).

M86.59

Other chronic hematogenous osteomyelitis, multiple sites

M86.50

Other chronic hematogenous osteomyelitis, unspecified site

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What qualifies as an 'other site' for M86.58?

Any bone not listed as a named 5th-character site in the M86.5x series — shoulder, humerus, radius/ulna, hand, femur, tibia/fibula, ankle/foot. Common 'other site' examples include the clavicle, pelvis, patella, ribs, sternum, and scapula. Orbit, petrous bone, and vertebra are excluded from M86 entirely and require H05.0-, H70.2-, or M46.2- respectively.

02Do I need to add a B95–B97 organism code with M86.58?

Yes, when the organism is documented. The M86 category carries a 'Use additional code' instruction for the infectious agent. If culture results or clinical documentation identify the pathogen (e.g., MRSA = B95.62, Staph aureus = B95.61), add the corresponding B95–B97 code as a secondary diagnosis.

03How do I distinguish M86.58 (hematogenous) from M86.68 (other chronic osteomyelitis, other site)?

M86.58 is reserved for bloodstream-seeded infection. M86.68 covers chronic osteomyelitis at other sites where the route is contiguous spread, direct inoculation, or unspecified. The provider must document 'hematogenous' to support M86.58; if the route is absent or unclear, query before assigning.

04Is a 7th-character extension required for M86.58?

No. M-codes in Chapter 13 do not use 7th-character extensions (A/D/S). Those are reserved for injury S-codes. M86.58 is a complete, billable code as a 5-character code.

05Can M86.58 be used for osteomyelitis of the vertebra at an 'other site'?

No. Vertebral osteomyelitis is excluded from the entire M86 category via an Excludes2 note. Code it with M46.2- (Osteomyelitis of vertebra). The Excludes2 designation means a patient can have both M86.58 and M46.2- simultaneously if different bones are affected, but vertebral infection itself cannot be coded under M86.

06When should I use M86.59 (multiple sites) instead of M86.58?

Use M86.59 when the provider documents chronic hematogenous osteomyelitis simultaneously involving multiple distinct bones, at least one of which falls in the 'other site' category. If all affected sites have specific named codes, use those site-specific codes together rather than defaulting to M86.59.

07Does diabetes mellitus change the coding for M86.58?

Yes. When a diabetic patient has osteomyelitis, sequence the diabetes code first (E10.69 or E11.69 for type 1 or type 2 with other complications) followed by M86.58, per the etiology/manifestation convention and ICD-10-CM Chapter 13 guidelines. Document the causal relationship between diabetes and the bone infection explicitly.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

The Mira AI Scribe captures the bone affected by name, the provider's explicit characterization of the infection as chronic and hematogenous, any documented causative organism, imaging findings (MRI marrow signal change, cortical destruction, sequestrum, involucrum), prior treatment history supporting chronicity, and presence of osseous defect. Capturing all these elements prevents downcoding to M86.9 (unspecified) and eliminates the audit flag triggered when organism codes are missing despite documented culture results.

See how Mira captures M86.58 documentation