E · Musculoskeletal Rehabilitation
One of the twelve PDGM clinical groups. CMS maps 19210 ICD-10-CM codes to it in grouper v07.2.26.
Group E
ICD-10-CM codes
19,210
Across 40 ICD-10-CM ranges, in grouper v07.2.26.
Functional bands
≤31 · 32–45 · 46+
OASIS points for low, medium and high functional impairment in this group.
LUPA thresholds
2 to 5 visits
Across the group’s 36 case-mix codes. Fewer visits than the threshold pays per visit.
Every HIPPS code in group E, with its LUPA threshold
1 · Community, Early
2 · Institutional, Early
3 · Community, Late
ICD-10-CM ranges that feed this group
- S80-S89Injuries to the knee and lower leg2657
- S60-S69Injuries to the wrist, hand and fingers2621
- S50-S59Injuries to the elbow and forearm2507
- S70-S79Injuries to the hip and thigh1985
- S90-S99Injuries to the ankle and foot1485
- S40-S49Injuries to the shoulder and upper arm1364
- M80-M85Osteopathies and chondropathies968
- M05-M14Inflammatory polyarthropathies774
- S30-S39Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals732
- S10-S19Injuries to the neck498
- M86-M90Other osteopathies453
- S20-S29Injuries to the thorax453
- M20-M25Other joint disorders413
- S00-S09Injuries to the head351
- M60-M63Soft tissue disorders243
- M65-M67Disorders of synovium and tendon240
- T80-T88Complications of surgical and medical care, not elsewhere classified239
- M45-M49Spondylopathies226
- M70-M79Other soft tissue disorders222
- M91-M94Chondropathies147
- M50-M54Other dorsopathies109
- M40-M43Dorsopathies105
- M99-M99Biomechanical lesions, not elsewhere classified90
- M15-M19Osteoarthritis68
- M00-M02Arthropathies65
- M30-M36Systemic connective tissue disorders59
- M97-M97Periprosthetic fracture around internal prosthetic joint33
- M96-M96Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified32
- Q65-Q79Congenital malformations and deformations of the musculoskeletal system30
- P10-P15Birth trauma11
- Z40-Z53Encounters for other specific health care7
- M26-M27Dentofacial anomalies [including malocclusion] and other disorders of jaw6
- A15-A19Tuberculosis4
- M95-M95Other disorders of the musculoskeletal system and connective tissue4
- M04-M04Autoinflammatory syndromes3
- A50-A64Infections with a predominantly sexual mode of transmission2
- A00-A09Intestinal infectious diseases1
- B00-B09Viral infections characterized by skin and mucous membrane lesions1
- D80-D89Certain disorders involving the immune mechanism1
- G40-G47Episodic and paroxysmal disorders1
What lands a period in this group
The clinical group is set by the principal diagnosis on the claim, and it is one of the five things that decide a 30-day period’s case-mix group, alongside admission source, timing, functional impairment level and comorbidity adjustment. CMS maps 19210 ICD-10-CM codes to Musculoskeletal Rehabilitation, spread across 40 ICD-10-CM ranges.
Those ranges are not always the ones you would expect from the chapter. Cerebrovascular disease sits in the circulatory chapter alongside heart failure, but CMS groups strokes as neurological rehabilitation, which is why the chapter a code lives in is a poor guide to how it pays.
The other eleven groups
- AMMTA - Other
- BNeuro Rehabilitation
- CWound
- DComplex Nursing Interventions
- FBehavioral Health
- GMMTA - Surgical Aftercare
- HMMTA - Cardiac and Circulatory
- IMMTA - Endocrine
- JMMTA - Gastrointestinal tract and Genitourinary system
- KMMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases
- LMMTA - Respiratory
Source: CMS HH PPS Grouper Software v07.2.26 for the codes and bands, read from the CMS table, not transcribed; CMS’s CY2026 case-mix weights and LUPA thresholds file for the thresholds. Not certified, endorsed or approved by CMS.
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