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

ICD-10 M16.0

Billable / Specific

Bilateral primary osteoarthritis of hip

M16
Block
0
Synonyms
462
LCDs
27
Payer Policies
8
Linked CPTs

About ICD-10-CM M16.0

ICD-10-CM code M16.0 represents Bilateral primary osteoarthritis of hip. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M16). The 2026 edition of ICD-10-CM M16.0 became effective on October 1, 2025.

Medicare LCD Coverage for M16.0

Local Coverage Determinations (LCDs) from CMS MACs that list M16.0 as a covered diagnosis.

462 LCDs

Showing top 10 of 462 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98942 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98940 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98941 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98943 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 27134 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 20985 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT S2900 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 27130 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 27487 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 27137 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M16.0.

27 policies

2 Cigna

Acupuncture - (CPG024)
Policy ID: CPG024_ACUPUNCTURE
Peripheral Nerve Destruction for Pain Conditions - (0525) ---- future effective policy
Policy ID: MM_0525

5 Medicare

Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026
Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
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 M16.0

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

8 linkages
  • 27430 Knee arthroplasty Orthopaedic Surgery
  • 27446 Knee replacement Orthopaedic Surgery
  • 27130 Total hip arthroplasty — primary hip OA, bilateral hip OA, osteonecrosis, femoral neck fracture, pathologic fracture Orthopedics
  • 27445 CMS LCD: Billing and Coding: Total Joint Arthroplasty CMS LCD
  • 0054T CMS LCD: Billing and Coding: Total Joint Arthroplasty CMS LCD
  • 20985 CMS LCD: Billing and Coding: Total Joint Arthroplasty CMS LCD
  • S2900 CMS LCD: Billing and Coding: Total Joint Arthroplasty CMS LCD
  • 0055T CMS LCD: Billing and Coding: Total Joint Arthroplasty CMS LCD

Convert M16.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M16.0 71515 10000

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

ICD-10 M16.0, Billing FAQ

Is ICD-10 code M16.0 billable? +

Yes, M16.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with M16.0? +

Procedures frequently paired with M16.0 include: 27430, 27446, 27130, 27445, 0054T.

What ICD-9 codes does M16.0 map to? +

Per CMS GEMs, M16.0 maps to ICD-9 codes: 71515. 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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