Is M13.162 a billable ICD-10-CM code?

Yes. M13.162 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M13.162 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 M13.162?

M13.162 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M13.162 (M13) and apply to it just the same.

M13.162

M13.162 — Monoarthritis, not elsewhere classified, left knee

Billable / specific codeICD-10-CMleft

M13.162 is a billable, specific ICD-10-CM code for monoarthritis, not elsewhere classified, left knee. It is valid for submission on a claim.

Excludes1 inherited from the categories above M13.162

These are not written on M13.162, but they bind it: a note on a category applies to every code beneath it. Billing M13.162 with anything listed here is a denial.

Written on M13 — Other arthritis

arthrosis (M15-M19)
osteoarthritis (M15-M19)

Risk adjustment

M13.162 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.

Medicare coverage

M13.162 is named in 11 Medicare coverage policies — 4 listing it as supporting medical necessity, and 7 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
A58883Billing 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

Code history

M13.162 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share M13.16. If M13.162 is not quite right, the correct code is usually one of these.

Questions about M13.162

Is M13.162 a billable ICD-10-CM code?: Yes. M13.162 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M13.162 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 M13.162?: M13.162 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M13.162 (M13) and apply to it just the same.