M76.9 — Unspecified enthesopathy, lower limb, excluding foot
M76.9 is a billable, specific ICD-10-CM code for unspecified enthesopathy, lower limb, excluding foot. It is valid for submission on a claim.
Risk adjustment
M76.9 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
M76.9 is named in 10 Medicare coverage policies — 4 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 M76.9 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 M76.9.
- Enthesopathy›lower limb(excluding foot)
Related codes at this level
Codes that share M76. If M76.9 is not quite right, the correct code is usually one of these.
Questions about M76.9
- Is M76.9 a billable ICD-10-CM code?
- Yes. M76.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M76.9 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other soft tissue disorders (M70-M79).