Is M79.5 a billable ICD-10-CM code?

Yes. M79.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M79.5 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other soft tissue disorders (M70-M79).

What cannot be coded together with M79.5?

M79.5 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 M79.5 (M79) and apply to it just the same.

M79.5

M79.5 — Residual foreign body in soft tissue

Billable / specific codeICD-10-CM

M79.5 is a billable, specific ICD-10-CM code for residual foreign body in soft tissue. 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.

foreign body granuloma of skin and subcutaneous tissue (L92.3)
foreign body granuloma of soft tissue (M60.2-)

Excludes1 inherited from the categories above M79.5

These are not written on M79.5, but they bind it: a note on a category applies to every code beneath it. Billing M79.5 with anything listed here is a denial.

Written on M79 — Other and unspecified soft tissue disorders, not elsewhere classified

psychogenic rheumatism (F45.8)
soft tissue pain, psychogenic (F45.41)

Other codes that can never be billed with M79.5

These codes carry an Excludes1 note pointing at M79.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M79.5 alone.

Z03.82Encounter for observation for suspected foreign body ruled out

Risk adjustment

M79.5 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

M79.5 is named in 14 Medicare coverage policies — 2 listing it as supporting medical necessity, and 12 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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

How M79.5 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 M79.5.

Foreign body›in›soft tissue(residual)
Foreign body›old or residual›soft tissue(residual)
Foreign body›retained›soft tissue

Code history

M79.5 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share M79. If M79.5 is not quite right, the correct code is usually one of these.

Questions about M79.5

Is M79.5 a billable ICD-10-CM code?: Yes. M79.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M79.5 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other soft tissue disorders (M70-M79).
What cannot be coded together with M79.5?: M79.5 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 M79.5 (M79) and apply to it just the same.