M12.5
M12.5 — Traumatic arthropathy
Non-billable headerICD-10-CM
M12.5 is a non-billable header ICD-10-CM code for traumatic arthropathy. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- current injury-see Alphabetic Index
- post-traumatic osteoarthritis of first carpometacarpal joint (M18.2-M18.3)
- post-traumatic osteoarthritis of hip (M16.4-M16.5)
- post-traumatic osteoarthritis of knee (M17.2-M17.3)
- post-traumatic osteoarthritis NOS (M19.1-)
- post-traumatic osteoarthritis of other single joints (M19.1-)
Risk adjustment
M12.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead M12.5
10 child codes. Green means billable.
- M12.50Traumatic arthropathy, unspecified site
- M12.51Traumatic arthropathy, shoulder
- M12.52Traumatic arthropathy, elbow
- M12.53Traumatic arthropathy, wrist
- M12.54Traumatic arthropathy, hand
- M12.55Traumatic arthropathy, hip
- M12.56Traumatic arthropathy, knee
- M12.57Traumatic arthropathy, ankle and foot
- M12.58Traumatic arthropathy, other specified site
- M12.59Traumatic arthropathy, multiple sites
Related codes at this level
Codes that share M12. If M12.5 is not quite right, the correct code is usually one of these.
Questions about M12.5
- Is M12.5 a billable ICD-10-CM code?
- No. M12.5 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M12.5 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).
- What cannot be coded together with M12.5?
- M12.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.