ICD-10 for Musculoskeletal

(Chapter 13)

Tags: icd10 musculoskeletal diagnosis

Code Range

M00-M99: Diseases of the musculoskeletal system and connective tissue

Key Categories for PM&R

Spine Conditions

Code	Description
M54.50	Low back pain, unspecified
M54.51	Vertebrogenic low back pain
M51.16	Lumbar intervertebral disc displacement
M54.16	Low back pain with radiculopathy
M48.06	Spinal stenosis, lumbar region

Joint Conditions

Code	Description
M17.11	Primary osteoarthritis, right knee
M17.12	Primary osteoarthritis, left knee
M19.011	Primary osteoarthritis, right shoulder
M25.561	Pain in right knee
M25.562	Pain in left knee

Soft Tissue Conditions

Code	Description
M76.51	Patellar tendinitis, right leg
M75.11	Rotator cuff syndrome, right shoulder
M77.11	Lateral epicondylitis, right elbow
M72.2	Plantar fascial fibromatosis

Required Specificity

Laterality

• 1 = Right
• 2 = Left
• 3 = Bilateral
• 0 = Unspecified (avoid when possible)

Episode of Care

• A = Initial encounter
• D = Subsequent encounter
• S = Sequela

Unspecified Codes

Avoid codes ending in “0” or “9” when more specific information is available. Unspecified codes are audit triggers.

Common Combinations

M54.16 (Low back pain with radiculopathy) + G55.1 (Nerve root compression)

Injury vs. Chronic

Use injury codes (S-codes) for acute trauma. Use M-codes for chronic/overuse conditions.

PM&R Coding MOC ICD-10 for Neurological