M79.0
M79.0: Rheumatism, unspecified
Billable / specific codeICD-10-CM
M79.0 is a billable, specific ICD-10-CM code for rheumatism, unspecified. It is valid for submission on a claim.
Check M79.0 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
M79.0 is named in 14 Medicare coverage policies: 2 listing it as supporting medical necessity, and 12 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A57701Billing and Coding: Trigger Point Injections (TPI)not covered
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58883Billing 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
Alphabetic index entries that lead here
- Rheumatism(articular) (neuralgic) (nonarticular)
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under M79
- M79.1Myalgia
- M79.2Neuralgia and neuritis, unspecified
- M79.3Panniculitis, unspecified
- M79.4Hypertrophy of (infrapatellar) fat pad
- M79.5Residual foreign body in soft tissue
- M79.6Pain in limb, hand, foot, fingers and toes
- M79.7Fibromyalgia
- M79.ANontraumatic compartment syndrome
- M79.8Other specified soft tissue disorders
- M79.9Soft tissue disorder, unspecified