Is M1A.2 a billable ICD-10-CM code?

No. M1A.2 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M1A.2 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).

M1A.2

M1A.2 — Drug-induced chronic gout

Non-billable headerICD-10-CM

M1A.2 is a non-billable header ICD-10-CM code for drug-induced chronic gout. It cannot be billed on its own: choose one of the more specific child codes below. This code also requires a 7th character before it is complete.

This code requires a 7th character

The appropriate 7th character is to be added to each code from category M1A

0: without tophus (tophi)
1: with tophus (tophi)

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Risk adjustment

M1A.2 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 M1A.2

10 child codes. Green means billable.

Related codes at this level

Codes that share M1A. If M1A.2 is not quite right, the correct code is usually one of these.

Questions about M1A.2

Is M1A.2 a billable ICD-10-CM code?: No. M1A.2 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M1A.2 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Inflammatory polyarthropathies (M05-M14).