Is M19.01 a billable ICD-10-CM code?

No. M19.01 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M19.01 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Osteoarthritis (M15-M19).

M19.01

M19.01 — Primary osteoarthritis, shoulder

Non-billable headerICD-10-CM

M19.01 is a non-billable header ICD-10-CM code for primary osteoarthritis, shoulder. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

M19.01 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 M19.01

3 child codes. Green means billable.

M19.011Primary osteoarthritis, right shoulder
M19.012Primary osteoarthritis, left shoulder
M19.019Primary osteoarthritis, unspecified shoulder

Related codes at this level

Codes that share M19.0. If M19.01 is not quite right, the correct code is usually one of these.

M19.02Primary osteoarthritis, elbow
M19.03Primary osteoarthritis, wrist
M19.04Primary osteoarthritis, hand
M19.07Primary osteoarthritis ankle and foot
M19.09Primary osteoarthritis, other specified site

Questions about M19.01

Is M19.01 a billable ICD-10-CM code?: No. M19.01 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M19.01 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Osteoarthritis (M15-M19).