Is M85.81 a billable ICD-10-CM code?

No. M85.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M85.81 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).

M85.81

M85.81 — Other specified disorders of bone density and structure, shoulder

Non-billable headerICD-10-CM

M85.81 is a non-billable header ICD-10-CM code for other specified disorders of bone density and structure, shoulder. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

M85.81 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.

Code to one of these instead M85.81

3 child codes. Green means billable.

Related codes at this level

Codes that share M85.8. If M85.81 is not quite right, the correct code is usually one of these.

Questions about M85.81

Is M85.81 a billable ICD-10-CM code?: No. M85.81 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M85.81 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).