Is M25.21 a billable ICD-10-CM code?

No. M25.21 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M25.21 sit in the tabular list?

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

M25.21

M25.21 — Flail joint, shoulder

Non-billable headerICD-10-CM

M25.21 is a non-billable header ICD-10-CM code for flail joint, shoulder. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes2 inherited from the categories above M25.21

Also inherited, and the opposite of Excludes1: these conditions are not part of M25.21, 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

M25.21 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 history

M25.21 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead M25.21

3 child codes. Green means billable.

Related codes at this level

Codes that share M25.2. If M25.21 is not quite right, the correct code is usually one of these.

Questions about M25.21

Is M25.21 a billable ICD-10-CM code?: No. M25.21 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M25.21 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other joint disorders (M20-M25).