M99.09 — Segmental and somatic dysfunction of abdomen and other regions
M99.09 is a billable, specific ICD-10-CM code for segmental and somatic dysfunction of abdomen and other regions. It is valid for submission on a claim.
Risk adjustment
M99.09 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
M99.09 is named in 8 Medicare coverage policies — 2 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 M99.09 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 M99.09.
- Dysfunction›somatic
- Dysfunction›somatic›abdomen
- Dysfunction›somatic›specified NEC
Related codes at this level
Codes that share M99.0. If M99.09 is not quite right, the correct code is usually one of these.
- M99.00Segmental and somatic dysfunction of head region
- M99.01Segmental and somatic dysfunction of cervical region
- M99.02Segmental and somatic dysfunction of thoracic region
- M99.03Segmental and somatic dysfunction of lumbar region
- M99.04Segmental and somatic dysfunction of sacral region
- M99.05Segmental and somatic dysfunction of pelvic region
- M99.06Segmental and somatic dysfunction of lower extremity
- M99.07Segmental and somatic dysfunction of upper extremity
- M99.08Segmental and somatic dysfunction of rib cage
Questions about M99.09
- Is M99.09 a billable ICD-10-CM code?
- Yes. M99.09 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M99.09 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Biomechanical lesions, not elsewhere classified (M99).