Is M26.55 a billable ICD-10-CM code?

Yes. M26.55 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M26.55 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Dentofacial anomalies [including malocclusion] and other disorders of jaw (M26-M27).

What cannot be coded together with M26.55?

M26.55 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

M26.55

M26.55 — Centric occlusion maximum intercuspation discrepancy

Billable / specific codeICD-10-CM

M26.55 is a billable, specific ICD-10-CM code for centric occlusion maximum intercuspation discrepancy. It is valid for submission on a claim.

Excludes1 — never code together

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

centric occlusion NOS (M26.59)

Risk adjustment

M26.55 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

M26.55 is named in 7 Medicare coverage policies — 1 listing it as supporting medical necessity, and 6 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
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
A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered

How M26.55 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M26.55.

Discrepancy›centric occlusion maximum intercuspation
Occlusion, occluded›centric›maximum intercuspation discrepancy

Related codes at this level

Codes that share M26.5. If M26.55 is not quite right, the correct code is usually one of these.

Questions about M26.55

Is M26.55 a billable ICD-10-CM code?: Yes. M26.55 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M26.55 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Dentofacial anomalies [including malocclusion] and other disorders of jaw (M26-M27).
What cannot be coded together with M26.55?: M26.55 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.