ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M12.211

Billable / Specific

Villonodular synovitis (pigmented), right shoulder

M12
Block
0
Synonyms
163
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM M12.211

ICD-10-CM code M12.211 represents Villonodular synovitis (pigmented), right shoulder. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M12). The 2026 edition of ICD-10-CM M12.211 became effective on October 1, 2025.

Medicare LCD Coverage for M12.211

Local Coverage Determinations (LCDs) from CMS MACs that list M12.211 as a covered diagnosis.

163 LCDs

Showing top 10 of 163 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29131 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29260 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29580 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97036 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29445 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97542 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29130 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29405 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M12.211.

2 policies

2 Medicare

Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065

CPT Codes Commonly Billed with M12.211

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for M12.211

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.

Convert M12.211 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M12.211 71921 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To M12.211

Other codes in section M05-M14 (Inflammatory polyarthropathies).

M05 Rheumatoid arthritis with rheumatoid factor (non-billable) M05.0 Felty's syndrome (non-billable) M05.00 Felty's syndrome, unspecified site M05.01 Felty's syndrome, shoulder (non-billable) M05.011 Felty's syndrome, right shoulder M05.012 Felty's syndrome, left shoulder M05.019 Felty's syndrome, unspecified shoulder M05.02 Felty's syndrome, elbow (non-billable) M05.021 Felty's syndrome, right elbow M05.022 Felty's syndrome, left elbow M05.029 Felty's syndrome, unspecified elbow M05.03 Felty's syndrome, wrist (non-billable) M05.031 Felty's syndrome, right wrist M05.032 Felty's syndrome, left wrist M05.039 Felty's syndrome, unspecified wrist M05.04 Felty's syndrome, hand (non-billable) M05.041 Felty's syndrome, right hand M05.042 Felty's syndrome, left hand M05.049 Felty's syndrome, unspecified hand M05.05 Felty's syndrome, hip (non-billable)

ICD-10 M12.211, Billing FAQ

Is ICD-10 code M12.211 billable? +

Yes, M12.211 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does M12.211 map to? +

Per CMS GEMs, M12.211 maps to ICD-9 codes: 71921. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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