M25.4

M25.4: Effusion of joint

Non-billable headerICD-10-CM

M25.4 is a non-billable header ICD-10-CM code for effusion of joint. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

hydrarthrosis in yaws (A66.6)
intermittent hydrarthrosis (M12.4-)
other infective (teno)synovitis (M65.1-)

Excludes2 inherited from the categories above M25.4

Not part of this code, but both may be coded when both are present.

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-)

Other codes that can never be billed with M25.4

Their own Excludes1 notes name this code, so the conflict is not listed above.

R22Localized swelling, mass and lump of skin and subcutaneous tissue

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead M25.4

9 child codes. Green means billable.