Is M63.81 a billable ICD-10-CM code?

No. M63.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M63.81 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of muscles (M60-M63).

What cannot be coded together with M63.81?

M63.81 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 M63.81 (M63) and apply to it just the same.

M63.81

M63.81 — Disorders of muscle in diseases classified elsewhere, shoulder

Non-billable headerICD-10-CM

M63.81 is a non-billable header ICD-10-CM code for disorders of muscle in diseases classified elsewhere, shoulder. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 inherited from the categories above M63.81

These are not written on M63.81, but they bind it: a note on a category applies to every code beneath it. Billing M63.81 with anything listed here is a denial.

Written on M63 — Disorders of muscle in diseases classified elsewhere

myopathy in cysticercosis (B69.81)
myopathy in endocrine diseases (G73.7)
myopathy in metabolic diseases (G73.7)
myopathy in sarcoidosis (D86.87)
myopathy in secondary syphilis (A51.49)
myopathy in syphilis (late) (A52.78)
myopathy in toxoplasmosis (B58.82)
myopathy in tuberculosis (A18.09)

Risk adjustment

M63.81 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

M63.81 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 M63.81

3 child codes. Green means billable.

Related codes at this level

Codes that share M63.8. If M63.81 is not quite right, the correct code is usually one of these.

Questions about M63.81

Is M63.81 a billable ICD-10-CM code?: No. M63.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M63.81 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of muscles (M60-M63).
What cannot be coded together with M63.81?: M63.81 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 M63.81 (M63) and apply to it just the same.