M16.4
M16.4: Bilateral post-traumatic osteoarthritis of hip
Billable / specific codeICD-10-CMbilateral
M16.4 is a billable, specific ICD-10-CM code for bilateral post-traumatic osteoarthritis of hip. It is valid for submission on a claim.
Check M16.4 with the rest of the claim: free scrubberOther codes that can never be billed with M16.4
Their own Excludes1 notes name this code, so the conflict is not listed above.
- M12.5Traumatic arthropathy
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
M16.4 is named in 24 Medicare coverage policies: 17 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- 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
Alphabetic index entries that lead here
- Osteoarthritis›hip›bilateral›post-traumatic
- Osteoarthritis›post-traumatic NEC›hip›bilateral
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under M16
- M16.0Bilateral primary osteoarthritis of hip
- M16.1Unilateral primary osteoarthritis of hip
- M16.2Bilateral osteoarthritis resulting from hip dysplasia
- M16.3Unilateral osteoarthritis resulting from hip dysplasia
- M16.5Unilateral post-traumatic osteoarthritis of hip
- M16.6Other bilateral secondary osteoarthritis of hip
- M16.7Other unilateral secondary osteoarthritis of hip
- M16.9Osteoarthritis of hip, unspecified