Is M85.519 a billable ICD-10-CM code?

Yes. M85.519 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M85.519 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 M85.519?

M85.519 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 M85.519 (M85) and apply to it just the same.

M85.519

M85.519 — Aneurysmal bone cyst, unspecified shoulder

Billable / specific codeICD-10-CMunspecified

M85.519 is a billable, specific ICD-10-CM code for aneurysmal bone cyst, unspecified shoulder. It is valid for submission on a claim.

Excludes1 inherited from the categories above M85.519

These are not written on M85.519, but they bind it: a note on a category applies to every code beneath it. Billing M85.519 with anything listed here is a denial.

Written on M85 — Other disorders of bone density and structure

osteogenesis imperfecta (Q78.0)
osteopetrosis (Q78.2)
osteopoikilosis (Q78.8)
polyostotic fibrous dysplasia (Q78.1)

Excludes2 inherited from the categories above M85.519

Also inherited, and the opposite of Excludes1: these conditions are not part of M85.519, but a patient can have both, so you may code both.

Written on M85.5 — Aneurysmal bone cyst

aneurysmal cyst of jaw (M27.4)

Risk adjustment

M85.519 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

M85.519 is named in 7 Medicare coverage policies — 0 listing it as supporting medical necessity, and 7 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
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
A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered

Code history

M85.519 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 M85.51. If M85.519 is not quite right, the correct code is usually one of these.

Questions about M85.519

Is M85.519 a billable ICD-10-CM code?: Yes. M85.519 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M85.519 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 M85.519?: M85.519 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 M85.519 (M85) and apply to it just the same.