M00.9 — Pyogenic arthritis, unspecified
M00.9 is a billable, specific ICD-10-CM code for pyogenic arthritis, unspecified. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Infective arthritis NOS
Risk adjustment
M00.9 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis0.479 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
M00.9 is named in 10 Medicare coverage policies — 4 listing it as supporting medical necessity, and 6 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
How M00.9 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M00.9.
- Arthritis, arthritic›pyogenic or pyemic(any site except spine)
- Infection, infected, infective›acromioclavicular
- Infection, infected, infective›hip NEC(joint)
- Infection, infected, infective›joint NEC
- Infection, infected, infective›knee NEC(joint)
- Infection, infected, infective›metatarsophalangeal
- Infection, infected, infective›shoulder NEC(joint)
- Abscess›knee›joint
- Disease, diseased›hip›suppurative
- Infection, infected, infective›knee NEC›joint
Related codes at this level
Codes that share M00. If M00.9 is not quite right, the correct code is usually one of these.
Questions about M00.9
- Is M00.9 a billable ICD-10-CM code?
- Yes. M00.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M00.9 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Infectious arthropathies (M00-M02).