2027 ICD-10-CM Diagnosis Code D86.87Sarcoid myositis
ICD-10-CM Codes›D50–D89›D80-D89›D86
- Billable — Valid for Submission
- Risk Adjusts — HCC 93
- Chronic Condition
D86.87 is a billable ICD-10-CM diagnosis code for sarcoid myositis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 196 through 198. Coders also document this condition as acute sarcoid polymyositis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Immunity disorders.
For Medicare Advantage risk adjustment, D86.87 maps to CMS-HCC Category 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders) under the V28 model, adding a risk factor of about 0.617 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
D86.87 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Acute sarcoid polymyositis
- Chronic sarcoid myopathy
- Fibromyositis
- Myositis in sarcoidosis
- Nodule in muscle
- Polymyositis
- Sarcoid myopathy
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to D86.87: its own notes plus those printed at block D80-D89 and Chapter 3. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- defects in the complement system
- immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
- sarcoidosis
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- human immunodeficiency virus [HIV] disease (B20)
- autoimmune disease (systemic) NOS (M35.9)
- certain conditions originating in the perinatal period (P00-P96)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- human immunodeficiency virus [HIV] disease (B20)
- 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)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name D86.87, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming D86.87: they are not reported together with it, unless the two conditions are unrelated.
Code First 1
These codes say to code first a condition named in the note, and D86.87 is one of the conditions named.
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Sarcoidosis
an idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. it usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands.
Patient EducationClinical
Sarcoidosis
Sarcoidosis is a condition in which groups of cells in your immune system form small, red, and swollen (inflamed) lumps. These lumps are called granulomas. They can form in any organ in the body. But they most commonly affect the lungs and lymph nodes in the chest. Over time, sarcoidosis can cause permanent scarring of organs.
The full article covers:
- What is sarcoidosis?
- What causes sarcoidosis?
- Who is more likely to develop sarcoidosis?
- What are the symptoms of sarcoidosis?
- What other problems can sarcoidosis cause?
- How is sarcoidosis diagnosed?
- What are the treatments for sarcoidosis?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert D86.87 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About D86.87Overview
What is the ICD-10 code for sarcoid myositis?
The ICD-10-CM code for sarcoid myositis is D86.87 (sometimes written as D8687). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is D86.87 (Sarcoidosis of other sites) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report sarcoid myositis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does D86.87 group to?
When sarcoid myositis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 198, 197, 196, with relative weights from 0.7256 to 1.8335 depending on complications. Higher weights mean higher Medicare reimbursement.
Can D86.87 be reported with M35.9?
Not as a rule. The Excludes1 note at block D80-D89, which applies to D86.87, lists "autoimmune disease (systemic) NOS (M35.9)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of D86.87?
Under the General Equivalence Mappings, sarcoid myositis converts to ICD-9-CM 135 (sarcoidosis). The mapping is approximate, so confirm the match fits the documentation.
What HCC is D86.87?
D86.87 (sarcoid myositis) maps to CMS-HCC Category 93 (Rheumatoid Arthritis and Other Specified Inflammatory Rheumatic Disorders), commonly written as HCC 93, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It does not map to any RxHCC in the Part D prescription drug model.
Does D86.87 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, D86.87 adds a risk adjustment factor of about 0.617 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.288 to 0.617 depending on the payment segment). HCC 93 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 93 category page.
