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.

Check M79.5 with the rest of the claim: free scrubber

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

A category’s note binds every code beneath it.

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

Their own Excludes1 notes name this code, so the conflict is not listed above.

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

Risk adjustment

No CMS-HCC V28 category: this code does not change 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 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