ICD-10 M07
Non-Billable HeaderEnteropathic arthropathies
About ICD-10-CM M07
ICD-10-CM code M07 represents Enteropathic arthropathies. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M07). The 2026 edition of ICD-10-CM M07 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with M07. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- psoriatic arthropathies (L40.5-)
Coding Notes
Code Also
- associated enteropathy, such as:
- regional enteritis [Crohn's disease] (K50.-)
- ulcerative colitis (K51.-)
Medicare LCD Coverage for M07
Local Coverage Determinations (LCDs) from CMS MACs that list M07 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M07.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M07 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with M07
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To M07
Other codes in section M05-M14 (Inflammatory polyarthropathies).
ICD-10 M07, Billing FAQ
Is ICD-10 code M07 billable? +
No, M07 is a non-billable header code. Use a more specific child code from block M07 when submitting claims.
What codes are Type 1 Excludes for M07? +
Type 1 Excludes (never code together with M07): psoriatic arthropathies (L40.5-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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