M86.452: Chronic osteomyelitis with draining sinus, left femur
M86.452, chronic osteomyelitis with draining sinus, left femur, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 10 HCPCS Level II codes, including A9552 (Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose…), A9598 (Positron emission tomography radiopharmaceutical…), A9601 (Flortaucipir f 18 injection, diagnostic, 1 millicurie). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M86.452 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | Carrier judgment | — | 1 |
| A9598 | Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified | Carrier judgment | — | 1 |
| A9601 | Flortaucipir f 18 injection, diagnostic, 1 millicurie | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| G0219 | Pet imaging whole body; melanoma for non-covered indications | Non-covered by Medicare | Not covered | 1 |
| G0235 | Pet imaging, any site, not otherwise specified | Non-covered by Medicare | Not covered | 1 |
| G0252 | Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes) | Non-covered by Medicare | Not covered | 1 |
Medicare policy articles listing M86.452
- A59318: Billing and Coding: Positron Emission Tomography (PET) Scan for Inflammation and Infection (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L39521
- A55909: Billing and Coding: Wound Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L35125, L37166, L37228
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M86 diagnoses (Osteomyelitis)
- M86.451 — Chronic osteomyelitis with draining sinus, right femur
Frequently asked questions
Does Medicare cover M86.452 (Chronic osteomyelitis with draining sinus, left femur)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list M86.452 as a covered diagnosis for 10 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M86.452?
The Level II codes from the policies most specific to this diagnosis are A9552 (Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose…, 1 article); A9598 (Positron emission tomography radiopharmaceutical…, 1 article); A9601 (Flortaucipir f 18 injection, diagnostic, 1 millicurie, 1 article); G0281 (Electrical stimulation, (unattended), to one or more…, 1 article); G0329 (Electromagnetic therapy, to one or more areas for chronic…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M86.452?
A59318 (Billing and Coding: Positron Emission Tomography (PET) Scan for Inflammation and Infection); A55909 (Billing and Coding: Wound Care); A57206 (Billing and Coding: Lumbar MRI).
What is ICD-10-CM code M86.452?
M86.452 is the ICD-10-CM code for chronic osteomyelitis with draining sinus, left femur, in category M86 (Osteomyelitis), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under A9552
- Watch A9552 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9552
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup