M95.5
M95.5: Acquired deformity of pelvis
Billable / specific codeICD-10-CM
M95.5 is a billable, specific ICD-10-CM code for acquired deformity of pelvis. It is valid for submission on a claim.
Check M95.5 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- maternal care for known or suspected disproportion (O33.-)
Excludes2 inherited from the categories above M95.5
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
M95.5 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
Alphabetic index entries that lead here
- Nägele's pelvis
- Platypelloid pelvis
- Contraction, contracture, contracted›pelvis(acquired) (general)
- Deformity›ilium(acquired)
- Deformity›ischium(acquired)
- Deformity›pelvis, pelvic(acquired) (bony)
- Flat›pelvis
- Funnel›pelvis(acquired)
- Infancy, infantile, infantilism›pelvis
- Tipping›pelvis
Code history
Unchanged in every release from FY2024 to FY2027.