Is M81.6 a billable ICD-10-CM code?

Yes. M81.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M81.6 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).

What cannot be coded together with M81.6?

M81.6 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

M81.6

M81.6 — Localized osteoporosis [Lequesne]

Billable / specific codeICD-10-CM

M81.6 is a billable, specific ICD-10-CM code for localized osteoporosis [lequesne]. 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.

Sudeck's atrophy (M89.0)

Risk adjustment

M81.6 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

M81.6 is named in 26 Medicare coverage policies — 20 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 M81.6 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 M81.6.

Osteoporosis›Lequesne
Osteoporosis›localized

Related codes at this level

Codes that share M81. If M81.6 is not quite right, the correct code is usually one of these.

Questions about M81.6

Is M81.6 a billable ICD-10-CM code?: Yes. M81.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M81.6 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of bone density and structure (M80-M85).
What cannot be coded together with M81.6?: M81.6 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.