M95.11
M95.11: Cauliflower ear, right ear
Billable / specific codeICD-10-CMright
M95.11 is a billable, specific ICD-10-CM code for cauliflower ear, right ear. It is valid for submission on a claim.
Check M95.11 with the rest of the claim: free scrubberExcludes2 inherited from the categories above M95.11
Not part of this code, but both may be coded when both are present.
Written on M95: Other acquired deformities of musculoskeletal system and connective tissue
- acquired absence of limbs and organs (Z89-Z90)
- acquired deformities of limbs (M20-M21)
- congenital malformations and deformations of the musculoskeletal system (Q65-Q79)
- deforming dorsopathies (M40-M43)
- dentofacial anomalies [including malocclusion] (M26.-)
- postprocedural musculoskeletal disorders (M96.-)
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
M95.11 is named in 7 Medicare coverage policies: 0 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- 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
Unchanged in every release from FY2024 to FY2027.