ICD-10 M16.11
Billable / SpecificUnilateral primary osteoarthritis, right hip
About ICD-10-CM M16.11
ICD-10-CM code M16.11 represents Unilateral primary osteoarthritis, right hip. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M16). The 2026 edition of ICD-10-CM M16.11 became effective on October 1, 2025.
Medicare LCD Coverage for M16.11
Local Coverage Determinations (LCDs) from CMS MACs that list M16.11 as a covered diagnosis.
Showing top 10 of 462 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M16.11.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with M16.11
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 20610 Joint injection major — knee OA, hip OA, shoulder OA, shoulder impingement, joint pain, meniscal derangement, synovitis, bursitis Orthopedics
- 27130 Total hip arthroplasty — primary hip OA, bilateral hip OA, osteonecrosis, femoral neck fracture, pathologic fracture Orthopedics
- 73721 MRI hip without contrast — hip pain, hip OA, femoral neck fracture, hip dislocation, AVN femoral head, sciatica, hip region pain 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 M16.11 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| M16.11 | 71515 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To M16.11
Other codes in section M15-M19 (Osteoarthritis).
ICD-10 M16.11, Billing FAQ
Is ICD-10 code M16.11 billable? +
Yes, M16.11 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 M16.11? +
Procedures frequently paired with M16.11 include: 20610, 27130, 73721, 27445, 0054T.
What ICD-9 codes does M16.11 map to? +
Per CMS GEMs, M16.11 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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