M26.9 — Dentofacial anomaly, unspecified
M26.9 is a billable, specific ICD-10-CM code for dentofacial anomaly, unspecified. It is valid for submission on a claim.
Risk adjustment
M26.9 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
M26.9 is named in 6 Medicare coverage policies — 0 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 M26.9 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 M26.9.
- Anomaly, anomalous›dentofacial
- Deformity›jaw(acquired) (congenital)
- Deformity›mandible(acquired) (congenital)
- Deformity›maxilla(acquired) (congenital)
Related codes at this level
Codes that share M26. If M26.9 is not quite right, the correct code is usually one of these.
- M26.0Major anomalies of jaw size
- M26.1Anomalies of jaw-cranial base relationship
- M26.2Anomalies of dental arch relationship
- M26.3Anomalies of tooth position of fully erupted tooth or teeth
- M26.4Malocclusion, unspecified
- M26.5Dentofacial functional abnormalities
- M26.6Temporomandibular joint disorders
- M26.7Dental alveolar anomalies
- M26.8Other dentofacial anomalies
Questions about M26.9
- Is M26.9 a billable ICD-10-CM code?
- Yes. M26.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M26.9 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).