Is M25.059 a billable ICD-10-CM code?

Yes. M25.059 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M25.059 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other joint disorders (M20-M25).

What cannot be coded together with M25.059?

M25.059 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 M25.059 (M25.0) and apply to it just the same.

M25.059

M25.059 — Hemarthrosis, unspecified hip

Billable / specific codeICD-10-CMunspecified

M25.059 is a billable, specific ICD-10-CM code for hemarthrosis, unspecified hip. It is valid for submission on a claim.

Excludes1 inherited from the categories above M25.059

These are not written on M25.059, but they bind it: a note on a category applies to every code beneath it. Billing M25.059 with anything listed here is a denial.

Written on M25.0 — Hemarthrosis

current injury - see injury of joint by body region
hemophilic arthropathy (M36.2)

Excludes2 inherited from the categories above M25.059

Also inherited, and the opposite of Excludes1: these conditions are not part of M25.059, but a patient can have both, so you may code both.

Written on M25 — Other joint disorder, not elsewhere classified

abnormality of gait and mobility (R26.-)
acquired deformities of limb (M20-M21)
calcification of bursa (M71.4-)
calcification of shoulder (joint) (M75.3)
calcification of tendon (M65.2-)
difficulty in walking (R26.2)
temporomandibular joint disorder (M26.6-)

Risk adjustment

M25.059 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

M25.059 is named in 7 Medicare coverage policies — 0 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

M25.059 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 M25.05. If M25.059 is not quite right, the correct code is usually one of these.

Questions about M25.059

Is M25.059 a billable ICD-10-CM code?: Yes. M25.059 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M25.059 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other joint disorders (M20-M25).
What cannot be coded together with M25.059?: M25.059 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 M25.059 (M25.0) and apply to it just the same.