ICD-10 · PDGM grouping
M12 Other and unspecified arthropathy
All 169 codes in the M12 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
169
Can lead a claim
113
Cannot lead a claim
56
What CMS assigns to M12
113 of the 169 codes group to Musculoskeletal Rehabilitation; 56 are assigned no clinical group. None of the 169 is assigned a comorbidity subgroup. 113 of the 169 can lead a claim.
Every code in M12
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| M12.0 Chronic postrheumatic arthropathy [Jaccoud] | ||||
| M12.00 | Chronic postrheumatic arthropathy [Jaccoud], unspecified siteCMS: Chronic postrheumatic arthropathy, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.01 Chronic postrheumatic arthropathy [Jaccoud], shoulder | ||||
| M12.011 | Chronic postrheumatic arthropathy [Jaccoud], right shoulder | Can lead a claim | E | None |
| M12.012 | Chronic postrheumatic arthropathy [Jaccoud], left shoulder | Can lead a claim | E | None |
| M12.019 | Chronic postrheumatic arthropathy [Jaccoud], unspecified shoulderCMS: Chronic postrheumatic arthropathy, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.02 Chronic postrheumatic arthropathy [Jaccoud], elbow | ||||
| M12.021 | Chronic postrheumatic arthropathy [Jaccoud], right elbow | Can lead a claim | E | None |
| M12.022 | Chronic postrheumatic arthropathy [Jaccoud], left elbow | Can lead a claim | E | None |
| M12.029 | Chronic postrheumatic arthropathy [Jaccoud], unspecified elbowCMS: Chronic postrheumatic arthropathy, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.03 Chronic postrheumatic arthropathy [Jaccoud], wrist | ||||
| M12.031 | Chronic postrheumatic arthropathy [Jaccoud], right wrist | Can lead a claim | E | None |
| M12.032 | Chronic postrheumatic arthropathy [Jaccoud], left wrist | Can lead a claim | E | None |
| M12.039 | Chronic postrheumatic arthropathy [Jaccoud], unspecified wristCMS: Chronic postrheumatic arthropathy, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.04 Chronic postrheumatic arthropathy [Jaccoud], hand | ||||
| M12.041 | Chronic postrheumatic arthropathy [Jaccoud], right hand | Can lead a claim | E | None |
| M12.042 | Chronic postrheumatic arthropathy [Jaccoud], left hand | Can lead a claim | E | None |
| M12.049 | Chronic postrheumatic arthropathy [Jaccoud], unspecified handCMS: Chronic postrheumatic arthropathy, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.05 Chronic postrheumatic arthropathy [Jaccoud], hip | ||||
| M12.051 | Chronic postrheumatic arthropathy [Jaccoud], right hip | Can lead a claim | E | None |
| M12.052 | Chronic postrheumatic arthropathy [Jaccoud], left hip | Can lead a claim | E | None |
| M12.059 | Chronic postrheumatic arthropathy [Jaccoud], unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.06 Chronic postrheumatic arthropathy [Jaccoud], knee | ||||
| M12.061 | Chronic postrheumatic arthropathy [Jaccoud], right knee | Can lead a claim | E | None |
| M12.062 | Chronic postrheumatic arthropathy [Jaccoud], left knee | Can lead a claim | E | None |
| M12.069 | Chronic postrheumatic arthropathy [Jaccoud], unspecified kneeCMS: Chronic postrheumatic arthropathy, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.07 Chronic postrheumatic arthropathy [Jaccoud], ankle and foot | ||||
| M12.071 | Chronic postrheumatic arthropathy [Jaccoud], right ankle and footCMS: Chronic postrheumatic arthropathy, right ankle and foot | Can lead a claim | E | None |
| M12.072 | Chronic postrheumatic arthropathy [Jaccoud], left ankle and footCMS: Chronic postrheumatic arthropathy, left ankle and foot | Can lead a claim | E | None |
| M12.079 | Chronic postrheumatic arthropathy [Jaccoud], unspecified ankle and footCMS: Chronic postrheumatic arthropathy, unsp ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.08 | Chronic postrheumatic arthropathy [Jaccoud], other specified siteCMS: Chronic postrheumatic arthropathy, other specified site | Can lead a claim | E | None |
| M12.09 | Chronic postrheumatic arthropathy [Jaccoud], multiple sites | Can lead a claim | E | None |
| M12.1 Kaschin-Beck disease | ||||
| M12.10 | Kaschin-Beck disease, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.11 Kaschin-Beck disease, shoulder | ||||
| M12.111 | Kaschin-Beck disease, right shoulder | Can lead a claim | E | None |
| M12.112 | Kaschin-Beck disease, left shoulder | Can lead a claim | E | None |
| M12.119 | Kaschin-Beck disease, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.12 Kaschin-Beck disease, elbow | ||||
| M12.121 | Kaschin-Beck disease, right elbow | Can lead a claim | E | None |
| M12.122 | Kaschin-Beck disease, left elbow | Can lead a claim | E | None |
| M12.129 | Kaschin-Beck disease, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.13 Kaschin-Beck disease, wrist | ||||
| M12.131 | Kaschin-Beck disease, right wrist | Can lead a claim | E | None |
| M12.132 | Kaschin-Beck disease, left wrist | Can lead a claim | E | None |
| M12.139 | Kaschin-Beck disease, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.14 Kaschin-Beck disease, hand | ||||
| M12.141 | Kaschin-Beck disease, right hand | Can lead a claim | E | None |
| M12.142 | Kaschin-Beck disease, left hand | Can lead a claim | E | None |
| M12.149 | Kaschin-Beck disease, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.15 Kaschin-Beck disease, hip | ||||
| M12.151 | Kaschin-Beck disease, right hip | Can lead a claim | E | None |
| M12.152 | Kaschin-Beck disease, left hip | Can lead a claim | E | None |
| M12.159 | Kaschin-Beck disease, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.16 Kaschin-Beck disease, knee | ||||
| M12.161 | Kaschin-Beck disease, right knee | Can lead a claim | E | None |
| M12.162 | Kaschin-Beck disease, left knee | Can lead a claim | E | None |
| M12.169 | Kaschin-Beck disease, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.17 Kaschin-Beck disease, ankle and foot | ||||
| M12.171 | Kaschin-Beck disease, right ankle and foot | Can lead a claim | E | None |
| M12.172 | Kaschin-Beck disease, left ankle and foot | Can lead a claim | E | None |
| M12.179 | Kaschin-Beck disease, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.18 | Kaschin-Beck disease, vertebrae | Can lead a claim | E | None |
| M12.19 | Kaschin-Beck disease, multiple sites | Can lead a claim | E | None |
| M12.2 Villonodular synovitis (pigmented) | ||||
| M12.20 | Villonodular synovitis (pigmented), unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.21 Villonodular synovitis (pigmented), shoulder | ||||
| M12.211 | Villonodular synovitis (pigmented), right shoulder | Can lead a claim | E | None |
| M12.212 | Villonodular synovitis (pigmented), left shoulder | Can lead a claim | E | None |
| M12.219 | Villonodular synovitis (pigmented), unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.22 Villonodular synovitis (pigmented), elbow | ||||
| M12.221 | Villonodular synovitis (pigmented), right elbow | Can lead a claim | E | None |
| M12.222 | Villonodular synovitis (pigmented), left elbow | Can lead a claim | E | None |
| M12.229 | Villonodular synovitis (pigmented), unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.23 Villonodular synovitis (pigmented), wrist | ||||
| M12.231 | Villonodular synovitis (pigmented), right wrist | Can lead a claim | E | None |
| M12.232 | Villonodular synovitis (pigmented), left wrist | Can lead a claim | E | None |
| M12.239 | Villonodular synovitis (pigmented), unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.24 Villonodular synovitis (pigmented), hand | ||||
| M12.241 | Villonodular synovitis (pigmented), right hand | Can lead a claim | E | None |
| M12.242 | Villonodular synovitis (pigmented), left hand | Can lead a claim | E | None |
| M12.249 | Villonodular synovitis (pigmented), unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.25 Villonodular synovitis (pigmented), hip | ||||
| M12.251 | Villonodular synovitis (pigmented), right hip | Can lead a claim | E | None |
| M12.252 | Villonodular synovitis (pigmented), left hip | Can lead a claim | E | None |
| M12.259 | Villonodular synovitis (pigmented), unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.26 Villonodular synovitis (pigmented), knee | ||||
| M12.261 | Villonodular synovitis (pigmented), right knee | Can lead a claim | E | None |
| M12.262 | Villonodular synovitis (pigmented), left knee | Can lead a claim | E | None |
| M12.269 | Villonodular synovitis (pigmented), unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.27 Villonodular synovitis (pigmented), ankle and foot | ||||
| M12.271 | Villonodular synovitis (pigmented), right ankle and foot | Can lead a claim | E | None |
| M12.272 | Villonodular synovitis (pigmented), left ankle and foot | Can lead a claim | E | None |
| M12.279 | Villonodular synovitis (pigmented), unspecified ankle and footCMS: Villonodular synovitis (pigmented), unsp ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.28 | Villonodular synovitis (pigmented), other specified site | Can lead a claim | E | None |
| M12.29 | Villonodular synovitis (pigmented), multiple sites | Can lead a claim | E | None |
| M12.3 Palindromic rheumatism | ||||
| M12.30 | Palindromic rheumatism, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.31 Palindromic rheumatism, shoulder | ||||
| M12.311 | Palindromic rheumatism, right shoulder | Can lead a claim | E | None |
| M12.312 | Palindromic rheumatism, left shoulder | Can lead a claim | E | None |
| M12.319 | Palindromic rheumatism, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.32 Palindromic rheumatism, elbow | ||||
| M12.321 | Palindromic rheumatism, right elbow | Can lead a claim | E | None |
| M12.322 | Palindromic rheumatism, left elbow | Can lead a claim | E | None |
| M12.329 | Palindromic rheumatism, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.33 Palindromic rheumatism, wrist | ||||
| M12.331 | Palindromic rheumatism, right wrist | Can lead a claim | E | None |
| M12.332 | Palindromic rheumatism, left wrist | Can lead a claim | E | None |
| M12.339 | Palindromic rheumatism, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.34 Palindromic rheumatism, hand | ||||
| M12.341 | Palindromic rheumatism, right hand | Can lead a claim | E | None |
| M12.342 | Palindromic rheumatism, left hand | Can lead a claim | E | None |
| M12.349 | Palindromic rheumatism, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.35 Palindromic rheumatism, hip | ||||
| M12.351 | Palindromic rheumatism, right hip | Can lead a claim | E | None |
| M12.352 | Palindromic rheumatism, left hip | Can lead a claim | E | None |
| M12.359 | Palindromic rheumatism, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.36 Palindromic rheumatism, knee | ||||
| M12.361 | Palindromic rheumatism, right knee | Can lead a claim | E | None |
| M12.362 | Palindromic rheumatism, left knee | Can lead a claim | E | None |
| M12.369 | Palindromic rheumatism, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.37 Palindromic rheumatism, ankle and foot | ||||
| M12.371 | Palindromic rheumatism, right ankle and foot | Can lead a claim | E | None |
| M12.372 | Palindromic rheumatism, left ankle and foot | Can lead a claim | E | None |
| M12.379 | Palindromic rheumatism, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.38 | Palindromic rheumatism, other specified site | Can lead a claim | E | None |
| M12.39 | Palindromic rheumatism, multiple sites | Can lead a claim | E | None |
| M12.4 Intermittent hydrarthrosis | ||||
| M12.40 | Intermittent hydrarthrosis, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.41 Intermittent hydrarthrosis, shoulder | ||||
| M12.411 | Intermittent hydrarthrosis, right shoulder | Can lead a claim | E | None |
| M12.412 | Intermittent hydrarthrosis, left shoulder | Can lead a claim | E | None |
| M12.419 | Intermittent hydrarthrosis, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.42 Intermittent hydrarthrosis, elbow | ||||
| M12.421 | Intermittent hydrarthrosis, right elbow | Can lead a claim | E | None |
| M12.422 | Intermittent hydrarthrosis, left elbow | Can lead a claim | E | None |
| M12.429 | Intermittent hydrarthrosis, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.43 Intermittent hydrarthrosis, wrist | ||||
| M12.431 | Intermittent hydrarthrosis, right wrist | Can lead a claim | E | None |
| M12.432 | Intermittent hydrarthrosis, left wrist | Can lead a claim | E | None |
| M12.439 | Intermittent hydrarthrosis, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.44 Intermittent hydrarthrosis, hand | ||||
| M12.441 | Intermittent hydrarthrosis, right hand | Can lead a claim | E | None |
| M12.442 | Intermittent hydrarthrosis, left hand | Can lead a claim | E | None |
| M12.449 | Intermittent hydrarthrosis, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.45 Intermittent hydrarthrosis, hip | ||||
| M12.451 | Intermittent hydrarthrosis, right hip | Can lead a claim | E | None |
| M12.452 | Intermittent hydrarthrosis, left hip | Can lead a claim | E | None |
| M12.459 | Intermittent hydrarthrosis, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.46 Intermittent hydrarthrosis, knee | ||||
| M12.461 | Intermittent hydrarthrosis, right knee | Can lead a claim | E | None |
| M12.462 | Intermittent hydrarthrosis, left knee | Can lead a claim | E | None |
| M12.469 | Intermittent hydrarthrosis, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.47 Intermittent hydrarthrosis, ankle and foot | ||||
| M12.471 | Intermittent hydrarthrosis, right ankle and foot | Can lead a claim | E | None |
| M12.472 | Intermittent hydrarthrosis, left ankle and foot | Can lead a claim | E | None |
| M12.479 | Intermittent hydrarthrosis, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.48 | Intermittent hydrarthrosis, other site | Can lead a claim | E | None |
| M12.49 | Intermittent hydrarthrosis, multiple sites | Can lead a claim | E | None |
| M12.5 Traumatic arthropathy | ||||
| M12.50 | Traumatic arthropathy, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.51 Traumatic arthropathy, shoulder | ||||
| M12.511 | Traumatic arthropathy, right shoulder | Can lead a claim | E | None |
| M12.512 | Traumatic arthropathy, left shoulder | Can lead a claim | E | None |
| M12.519 | Traumatic arthropathy, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.52 Traumatic arthropathy, elbow | ||||
| M12.521 | Traumatic arthropathy, right elbow | Can lead a claim | E | None |
| M12.522 | Traumatic arthropathy, left elbow | Can lead a claim | E | None |
| M12.529 | Traumatic arthropathy, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.53 Traumatic arthropathy, wrist | ||||
| M12.531 | Traumatic arthropathy, right wrist | Can lead a claim | E | None |
| M12.532 | Traumatic arthropathy, left wrist | Can lead a claim | E | None |
| M12.539 | Traumatic arthropathy, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.54 Traumatic arthropathy, hand | ||||
| M12.541 | Traumatic arthropathy, right hand | Can lead a claim | E | None |
| M12.542 | Traumatic arthropathy, left hand | Can lead a claim | E | None |
| M12.549 | Traumatic arthropathy, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.55 Traumatic arthropathy, hip | ||||
| M12.551 | Traumatic arthropathy, right hip | Can lead a claim | E | None |
| M12.552 | Traumatic arthropathy, left hip | Can lead a claim | E | None |
| M12.559 | Traumatic arthropathy, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.56 Traumatic arthropathy, knee | ||||
| M12.561 | Traumatic arthropathy, right knee | Can lead a claim | E | None |
| M12.562 | Traumatic arthropathy, left knee | Can lead a claim | E | None |
| M12.569 | Traumatic arthropathy, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.57 Traumatic arthropathy, ankle and foot | ||||
| M12.571 | Traumatic arthropathy, right ankle and foot | Can lead a claim | E | None |
| M12.572 | Traumatic arthropathy, left ankle and foot | Can lead a claim | E | None |
| M12.579 | Traumatic arthropathy, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.58 | Traumatic arthropathy, other specified site | Can lead a claim | E | None |
| M12.59 | Traumatic arthropathy, multiple sites | Can lead a claim | E | None |
| M12.8 Other specific arthropathies, not elsewhere classified | ||||
| M12.80 | Other specific arthropathies, not elsewhere classified, unspecified siteCMS: Oth specific arthropathies, NEC, unsp site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.81 Other specific arthropathies, not elsewhere classified, shoulder | ||||
| M12.811 | Other specific arthropathies, not elsewhere classified, right shoulderCMS: Oth specific arthropathies, NEC, right shoulder | Can lead a claim | E | None |
| M12.812 | Other specific arthropathies, not elsewhere classified, left shoulderCMS: Oth specific arthropathies, NEC, left shoulder | Can lead a claim | E | None |
| M12.819 | Other specific arthropathies, not elsewhere classified, unspecified shoulderCMS: Oth specific arthropathies, NEC, unsp shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.82 Other specific arthropathies, not elsewhere classified, elbow | ||||
| M12.821 | Other specific arthropathies, not elsewhere classified, right elbowCMS: Oth specific arthropathies, NEC, right elbow | Can lead a claim | E | None |
| M12.822 | Other specific arthropathies, not elsewhere classified, left elbowCMS: Oth specific arthropathies, NEC, left elbow | Can lead a claim | E | None |
| M12.829 | Other specific arthropathies, not elsewhere classified, unspecified elbowCMS: Oth specific arthropathies, NEC, unsp elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.83 Other specific arthropathies, not elsewhere classified, wrist | ||||
| M12.831 | Other specific arthropathies, not elsewhere classified, right wristCMS: Oth specific arthropathies, NEC, right wrist | Can lead a claim | E | None |
| M12.832 | Other specific arthropathies, not elsewhere classified, left wristCMS: Oth specific arthropathies, NEC, left wrist | Can lead a claim | E | None |
| M12.839 | Other specific arthropathies, not elsewhere classified, unspecified wristCMS: Oth specific arthropathies, NEC, unsp wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.84 Other specific arthropathies, not elsewhere classified, hand | ||||
| M12.841 | Other specific arthropathies, not elsewhere classified, right handCMS: Oth specific arthropathies, NEC, right hand | Can lead a claim | E | None |
| M12.842 | Other specific arthropathies, not elsewhere classified, left handCMS: Oth specific arthropathies, NEC, left hand | Can lead a claim | E | None |
| M12.849 | Other specific arthropathies, not elsewhere classified, unspecified handCMS: Oth specific arthropathies, NEC, unsp hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.85 Other specific arthropathies, not elsewhere classified, hip | ||||
| M12.851 | Other specific arthropathies, not elsewhere classified, right hipCMS: Oth specific arthropathies, NEC, right hip | Can lead a claim | E | None |
| M12.852 | Other specific arthropathies, not elsewhere classified, left hipCMS: Oth specific arthropathies, NEC, left hip | Can lead a claim | E | None |
| M12.859 | Other specific arthropathies, not elsewhere classified, unspecified hipCMS: Oth specific arthropathies, NEC, unsp hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.86 Other specific arthropathies, not elsewhere classified, knee | ||||
| M12.861 | Other specific arthropathies, not elsewhere classified, right kneeCMS: Oth specific arthropathies, NEC, right knee | Can lead a claim | E | None |
| M12.862 | Other specific arthropathies, not elsewhere classified, left kneeCMS: Oth specific arthropathies, NEC, left knee | Can lead a claim | E | None |
| M12.869 | Other specific arthropathies, not elsewhere classified, unspecified kneeCMS: Oth specific arthropathies, NEC, unsp knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.87 Other specific arthropathies, not elsewhere classified, ankle and foot | ||||
| M12.871 | Other specific arthropathies, not elsewhere classified, right ankle and footCMS: Oth specific arthropathies, NEC, right ankle and foot | Can lead a claim | E | None |
| M12.872 | Other specific arthropathies, not elsewhere classified, left ankle and footCMS: Oth specific arthropathies, NEC, left ankle and foot | Can lead a claim | E | None |
| M12.879 | Other specific arthropathies, not elsewhere classified, unspecified ankle and footCMS: Oth specific arthropathies, NEC, unsp ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M12.88 | Other specific arthropathies, not elsewhere classified, other specified siteCMS: Oth specific arthropathies, NEC, oth site | Can lead a claim | E | None |
| M12.89 | Other specific arthropathies, not elsewhere classified, multiple sitesCMS: Oth specific arthropathies, NEC, multiple sites | Can lead a claim | E | None |
| M12.9 | Arthropathy, unspecified | Can lead a claim | E | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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