ICD-10 · PDGM grouping
M25 Other joint disorder, not elsewhere classified
All 225 codes in the M25 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
225
Can lead a claim
113
Cannot lead a claim
112
What CMS assigns to M25
113 of the 225 codes group to Musculoskeletal Rehabilitation; 112 are assigned no clinical group. 14 of the 225 count toward the Joint Pain comorbidity subgroup; 211 are assigned none. 113 of the 225 can lead a claim.
- Joint Pain: counts toward the high comorbidity tier only in an interaction pair.
Every code in M25
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 |
|---|---|---|---|---|
| M25.0 Hemarthrosis | ||||
| M25.00 | Hemarthrosis, unspecified joint | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.01 Hemarthrosis, shoulder | ||||
| M25.011 | Hemarthrosis, right shoulder | Can lead a claim | E | None |
| M25.012 | Hemarthrosis, left shoulder | Can lead a claim | E | None |
| M25.019 | Hemarthrosis, unspecified shoulder | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.02 Hemarthrosis, elbow | ||||
| M25.021 | Hemarthrosis, right elbow | Can lead a claim | E | None |
| M25.022 | Hemarthrosis, left elbow | Can lead a claim | E | None |
| M25.029 | Hemarthrosis, unspecified elbow | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.03 Hemarthrosis, wrist | ||||
| M25.031 | Hemarthrosis, right wrist | Can lead a claim | E | None |
| M25.032 | Hemarthrosis, left wrist | Can lead a claim | E | None |
| M25.039 | Hemarthrosis, unspecified wrist | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.04 Hemarthrosis, hand | ||||
| M25.041 | Hemarthrosis, right hand | Can lead a claim | E | None |
| M25.042 | Hemarthrosis, left hand | Can lead a claim | E | None |
| M25.049 | Hemarthrosis, unspecified hand | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.05 Hemarthrosis, hip | ||||
| M25.051 | Hemarthrosis, right hip | Can lead a claim | E | None |
| M25.052 | Hemarthrosis, left hip | Can lead a claim | E | None |
| M25.059 | Hemarthrosis, unspecified hip | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.06 Hemarthrosis, knee | ||||
| M25.061 | Hemarthrosis, right knee | Can lead a claim | E | None |
| M25.062 | Hemarthrosis, left knee | Can lead a claim | E | None |
| M25.069 | Hemarthrosis, unspecified knee | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.07 Hemarthrosis, ankle and foot | ||||
| M25.071 | Hemarthrosis, right ankle | Can lead a claim | E | None |
| M25.072 | Hemarthrosis, left ankle | Can lead a claim | E | None |
| M25.073 | Hemarthrosis, unspecified ankle | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.074 | Hemarthrosis, right foot | Can lead a claim | E | None |
| M25.075 | Hemarthrosis, left foot | Can lead a claim | E | None |
| M25.076 | Hemarthrosis, unspecified foot | Cannot lead a claimUnspecified diagnosis code not acceptable as principal diagnosis since there is a more specific code available that would further accurately identify the condition | None | None |
| M25.08 | Hemarthrosis, other specified site | Can lead a claim | E | None |
| M25.1 Fistula of joint | ||||
| M25.10 | Fistula, unspecified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.11 Fistula, shoulder | ||||
| M25.111 | Fistula, right shoulder | Can lead a claim | E | None |
| M25.112 | Fistula, left shoulder | Can lead a claim | E | None |
| M25.119 | Fistula, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.12 Fistula, elbow | ||||
| M25.121 | Fistula, right elbow | Can lead a claim | E | None |
| M25.122 | Fistula, left elbow | Can lead a claim | E | None |
| M25.129 | Fistula, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.13 Fistula, wrist | ||||
| M25.131 | Fistula, right wrist | Can lead a claim | E | None |
| M25.132 | Fistula, left wrist | Can lead a claim | E | None |
| M25.139 | Fistula, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.14 Fistula, hand | ||||
| M25.141 | Fistula, right hand | Can lead a claim | E | None |
| M25.142 | Fistula, left hand | Can lead a claim | E | None |
| M25.149 | Fistula, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.15 Fistula, hip | ||||
| M25.151 | Fistula, right hip | Can lead a claim | E | None |
| M25.152 | Fistula, left hip | Can lead a claim | E | None |
| M25.159 | Fistula, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.16 Fistula, knee | ||||
| M25.161 | Fistula, right knee | Can lead a claim | E | None |
| M25.162 | Fistula, left knee | Can lead a claim | E | None |
| M25.169 | Fistula, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.17 Fistula, ankle and foot | ||||
| M25.171 | Fistula, right ankle | Can lead a claim | E | None |
| M25.172 | Fistula, left ankle | Can lead a claim | E | None |
| M25.173 | Fistula, unspecified ankle | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.174 | Fistula, right foot | Can lead a claim | E | None |
| M25.175 | Fistula, left foot | Can lead a claim | E | None |
| M25.176 | Fistula, unspecified foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.18 | Fistula, other specified site | Can lead a claim | E | None |
| M25.2 Flail joint | ||||
| M25.20 | Flail joint, unspecified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.21 Flail joint, shoulder | ||||
| M25.211 | Flail joint, right shoulder | Can lead a claim | E | None |
| M25.212 | Flail joint, left shoulder | Can lead a claim | E | None |
| M25.219 | Flail joint, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.22 Flail joint, elbow | ||||
| M25.221 | Flail joint, right elbow | Can lead a claim | E | None |
| M25.222 | Flail joint, left elbow | Can lead a claim | E | None |
| M25.229 | Flail joint, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.23 Flail joint, wrist | ||||
| M25.231 | Flail joint, right wrist | Can lead a claim | E | None |
| M25.232 | Flail joint, left wrist | Can lead a claim | E | None |
| M25.239 | Flail joint, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.24 Flail joint, hand | ||||
| M25.241 | Flail joint, right hand | Can lead a claim | E | None |
| M25.242 | Flail joint, left hand | Can lead a claim | E | None |
| M25.249 | Flail joint, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.25 Flail joint, hip | ||||
| M25.251 | Flail joint, right hip | Can lead a claim | E | None |
| M25.252 | Flail joint, left hip | Can lead a claim | E | None |
| M25.259 | Flail joint, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.26 Flail joint, knee | ||||
| M25.261 | Flail joint, right knee | Can lead a claim | E | None |
| M25.262 | Flail joint, left knee | Can lead a claim | E | None |
| M25.269 | Flail joint, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.27 Flail joint, ankle and foot | ||||
| M25.271 | Flail joint, right ankle and foot | Can lead a claim | E | None |
| M25.272 | Flail joint, left ankle and foot | Can lead a claim | E | None |
| M25.279 | Flail joint, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.28 | Flail joint, other site | Can lead a claim | E | None |
| M25.3 Other instability of joint | ||||
| M25.30 | Other instability, unspecified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.31 Other instability, shoulder | ||||
| M25.311 | Other instability, right shoulder | Can lead a claim | E | None |
| M25.312 | Other instability, left shoulder | Can lead a claim | E | None |
| M25.319 | Other instability, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.32 Other instability, elbow | ||||
| M25.321 | Other instability, right elbow | Can lead a claim | E | None |
| M25.322 | Other instability, left elbow | Can lead a claim | E | None |
| M25.329 | Other instability, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.33 Other instability, wrist | ||||
| M25.331 | Other instability, right wrist | Can lead a claim | E | None |
| M25.332 | Other instability, left wrist | Can lead a claim | E | None |
| M25.339 | Other instability, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.34 Other instability, hand | ||||
| M25.341 | Other instability, right hand | Can lead a claim | E | None |
| M25.342 | Other instability, left hand | Can lead a claim | E | None |
| M25.349 | Other instability, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.35 Other instability, hip | ||||
| M25.351 | Other instability, right hip | Can lead a claim | E | None |
| M25.352 | Other instability, left hip | Can lead a claim | E | None |
| M25.359 | Other instability, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.36 Other instability, knee | ||||
| M25.361 | Other instability, right knee | Can lead a claim | E | None |
| M25.362 | Other instability, left knee | Can lead a claim | E | None |
| M25.369 | Other instability, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.37 Other instability, ankle and foot | ||||
| M25.371 | Other instability, right ankle | Can lead a claim | E | None |
| M25.372 | Other instability, left ankle | Can lead a claim | E | None |
| M25.373 | Other instability, unspecified ankle | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.374 | Other instability, right foot | Can lead a claim | E | None |
| M25.375 | Other instability, left foot | Can lead a claim | E | None |
| M25.376 | Other instability, unspecified foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.39 | Other instability, other specified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.4 Effusion of joint | ||||
| M25.40 | Effusion, unspecified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.41 Effusion, shoulder | ||||
| M25.411 | Effusion, right shoulder | Can lead a claim | E | None |
| M25.412 | Effusion, left shoulder | Can lead a claim | E | None |
| M25.419 | Effusion, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.42 Effusion, elbow | ||||
| M25.421 | Effusion, right elbow | Can lead a claim | E | None |
| M25.422 | Effusion, left elbow | Can lead a claim | E | None |
| M25.429 | Effusion, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.43 Effusion, wrist | ||||
| M25.431 | Effusion, right wrist | Can lead a claim | E | None |
| M25.432 | Effusion, left wrist | Can lead a claim | E | None |
| M25.439 | Effusion, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.44 Effusion, hand | ||||
| M25.441 | Effusion, right hand | Can lead a claim | E | None |
| M25.442 | Effusion, left hand | Can lead a claim | E | None |
| M25.449 | Effusion, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.45 Effusion, hip | ||||
| M25.451 | Effusion, right hip | Can lead a claim | E | None |
| M25.452 | Effusion, left hip | Can lead a claim | E | None |
| M25.459 | Effusion, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.46 Effusion, knee | ||||
| M25.461 | Effusion, right knee | Can lead a claim | E | None |
| M25.462 | Effusion, left knee | Can lead a claim | E | None |
| M25.469 | Effusion, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.47 Effusion, ankle and foot | ||||
| M25.471 | Effusion, right ankle | Can lead a claim | E | None |
| M25.472 | Effusion, left ankle | Can lead a claim | E | None |
| M25.473 | Effusion, unspecified ankle | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.474 | Effusion, right foot | Can lead a claim | E | None |
| M25.475 | Effusion, left foot | Can lead a claim | E | None |
| M25.476 | Effusion, unspecified foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.48 | Effusion, other site | Can lead a claim | E | None |
| M25.5 Pain in joint | ||||
| M25.50 | Pain in unspecified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.51 Pain in shoulder | ||||
| M25.511 | Pain in right shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.512 | Pain in left shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.519 | Pain in unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.52 Pain in elbow | ||||
| M25.521 | Pain in right elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.522 | Pain in left elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.529 | Pain in unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.53 Pain in wrist | ||||
| M25.531 | Pain in right wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.532 | Pain in left wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.539 | Pain in unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.54 Pain in joints of hand | ||||
| M25.541 | Pain in joints of right hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.542 | Pain in joints of left hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.549 | Pain in joints of unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.55 Pain in hip | ||||
| M25.551 | Pain in right hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.552 | Pain in left hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.559 | Pain in unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.56 Pain in knee | ||||
| M25.561 | Pain in right knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.562 | Pain in left knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.569 | Pain in unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.57 Pain in ankle and joints of foot | ||||
| M25.571 | Pain in right ankle and joints of right foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.572 | Pain in left ankle and joints of left foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | Joint Pain |
| M25.579 | Pain in unspecified ankle and joints of unspecified foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.59 | Pain in other specified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.6 Stiffness of joint, not elsewhere classified | ||||
| M25.60 | Stiffness of unspecified joint, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.61 Stiffness of shoulder, not elsewhere classified | ||||
| M25.611 | Stiffness of right shoulder, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.612 | Stiffness of left shoulder, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.619 | Stiffness of unspecified shoulder, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.62 Stiffness of elbow, not elsewhere classified | ||||
| M25.621 | Stiffness of right elbow, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.622 | Stiffness of left elbow, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.629 | Stiffness of unspecified elbow, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.63 Stiffness of wrist, not elsewhere classified | ||||
| M25.631 | Stiffness of right wrist, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.632 | Stiffness of left wrist, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.639 | Stiffness of unspecified wrist, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.64 Stiffness of hand, not elsewhere classified | ||||
| M25.641 | Stiffness of right hand, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.642 | Stiffness of left hand, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.649 | Stiffness of unspecified hand, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.65 Stiffness of hip, not elsewhere classified | ||||
| M25.651 | Stiffness of right hip, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.652 | Stiffness of left hip, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.659 | Stiffness of unspecified hip, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.66 Stiffness of knee, not elsewhere classified | ||||
| M25.661 | Stiffness of right knee, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.662 | Stiffness of left knee, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.669 | Stiffness of unspecified knee, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.67 Stiffness of ankle and foot, not elsewhere classified | ||||
| M25.671 | Stiffness of right ankle, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.672 | Stiffness of left ankle, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.673 | Stiffness of unspecified ankle, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.674 | Stiffness of right foot, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.675 | Stiffness of left foot, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.676 | Stiffness of unspecified foot, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.69 | Stiffness of other specified joint, not elsewhere classified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.7 Osteophyte | ||||
| M25.70 | Osteophyte, unspecified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.71 Osteophyte, shoulder | ||||
| M25.711 | Osteophyte, right shoulder | Can lead a claim | E | None |
| M25.712 | Osteophyte, left shoulder | Can lead a claim | E | None |
| M25.719 | Osteophyte, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.72 Osteophyte, elbow | ||||
| M25.721 | Osteophyte, right elbow | Can lead a claim | E | None |
| M25.722 | Osteophyte, left elbow | Can lead a claim | E | None |
| M25.729 | Osteophyte, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.73 Osteophyte, wrist | ||||
| M25.731 | Osteophyte, right wrist | Can lead a claim | E | None |
| M25.732 | Osteophyte, left wrist | Can lead a claim | E | None |
| M25.739 | Osteophyte, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.74 Osteophyte, hand | ||||
| M25.741 | Osteophyte, right hand | Can lead a claim | E | None |
| M25.742 | Osteophyte, left hand | Can lead a claim | E | None |
| M25.749 | Osteophyte, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.75 Osteophyte, hip | ||||
| M25.751 | Osteophyte, right hip | Can lead a claim | E | None |
| M25.752 | Osteophyte, left hip | Can lead a claim | E | None |
| M25.759 | Osteophyte, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.76 Osteophyte, knee | ||||
| M25.761 | Osteophyte, right knee | Can lead a claim | E | None |
| M25.762 | Osteophyte, left knee | Can lead a claim | E | None |
| M25.769 | Osteophyte, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.77 Osteophyte, ankle and foot | ||||
| M25.771 | Osteophyte, right ankle | Can lead a claim | E | None |
| M25.772 | Osteophyte, left ankle | Can lead a claim | E | None |
| M25.773 | Osteophyte, unspecified ankle | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.774 | Osteophyte, right foot | Can lead a claim | E | None |
| M25.775 | Osteophyte, left foot | Can lead a claim | E | None |
| M25.776 | Osteophyte, unspecified foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.78 | Osteophyte, vertebrae | Can lead a claim | E | None |
| M25.8 Other specified joint disorders | ||||
| M25.80 | Other specified joint disorders, unspecified joint | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.81 Other specified joint disorders, shoulder | ||||
| M25.811 | Other specified joint disorders, right shoulder | Can lead a claim | E | None |
| M25.812 | Other specified joint disorders, left shoulder | Can lead a claim | E | None |
| M25.819 | Other specified joint disorders, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.82 Other specified joint disorders, elbow | ||||
| M25.821 | Other specified joint disorders, right elbow | Can lead a claim | E | None |
| M25.822 | Other specified joint disorders, left elbow | Can lead a claim | E | None |
| M25.829 | Other specified joint disorders, unspecified elbow | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.83 Other specified joint disorders, wrist | ||||
| M25.831 | Other specified joint disorders, right wrist | Can lead a claim | E | None |
| M25.832 | Other specified joint disorders, left wrist | Can lead a claim | E | None |
| M25.839 | Other specified joint disorders, unspecified wrist | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.84 Other specified joint disorders, hand | ||||
| M25.841 | Other specified joint disorders, right hand | Can lead a claim | E | None |
| M25.842 | Other specified joint disorders, left hand | Can lead a claim | E | None |
| M25.849 | Other specified joint disorders, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.85 Other specified joint disorders, hip | ||||
| M25.851 | Other specified joint disorders, right hip | Can lead a claim | E | None |
| M25.852 | Other specified joint disorders, left hip | Can lead a claim | E | None |
| M25.859 | Other specified joint disorders, unspecified hip | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.86 Other specified joint disorders, knee | ||||
| M25.861 | Other specified joint disorders, right knee | Can lead a claim | E | None |
| M25.862 | Other specified joint disorders, left knee | Can lead a claim | E | None |
| M25.869 | Other specified joint disorders, unspecified knee | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.87 Other specified joint disorders, ankle and foot | ||||
| M25.871 | Other specified joint disorders, right ankle and foot | Can lead a claim | E | None |
| M25.872 | Other specified joint disorders, left ankle and foot | Can lead a claim | E | None |
| M25.879 | Other specified joint disorders, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M25.9 | Joint disorder, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | 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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