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

ICD-10 M17.11

Billable / Specific

Unilateral primary osteoarthritis, right knee

M17
Block
0
Synonyms
496
LCDs
25
Payer Policies
27
Linked CPTs

About ICD-10-CM M17.11

ICD-10-CM code M17.11 represents Unilateral primary osteoarthritis, right knee. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M17). The 2026 edition of ICD-10-CM M17.11 became effective on October 1, 2025.

Medicare LCD Coverage for M17.11

Local Coverage Determinations (LCDs) from CMS MACs that list M17.11 as a covered diagnosis.

496 LCDs

Showing top 10 of 496 total . Click a CPT for full coverage scope.

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 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 27486 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 27138 →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 0055T →
CMS LCD: Billing and Coding: Total Joint Arthroplasty
Article ID: 60249, Effective: , 1313 covered, 0 non-covered
CPT 27445 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M17.11.

25 policies

1 Cigna

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

5 Medicare

Billing and Coding: Hyaluronans Intra-articular Injections of
Policy ID: ART-52420
Knee Orthoses - Policy Article
Policy ID: ART-52465
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

CPT Codes Commonly Billed with M17.11

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

27 linkages
  • 27447 Total knee arthroplasty — osteoarthritis Orthopaedic Surgery
  • 20610 Joint injection major — knee OA, hip OA, shoulder OA, shoulder impingement, joint pain, meniscal derangement, synovitis, bursitis Orthopedics
  • 27447 Total knee arthroplasty — primary knee OA unilateral/bilateral, post-traumatic OA, osteonecrosis Orthopedics
  • 27446 Revision knee arthroplasty — failed TKA, mechanical loosening, component failure Orthopedics
  • 73721 MRI knee without contrast — knee pain, meniscal derangement, meniscal tear, patellar tendinitis, knee OA, ACL injury Orthopedics
  • 97110 Therapeutic exercises — back pain, neck pain, joint pain, rotator cuff, knee OA, limb pain, meniscal tear, shoulder injury, ankle sprain, hemiplegia, paraplegia, post joint replacement, muscle weakness Physical Therapy
  • 97161 PT evaluation low complexity — back pain, neck pain, joint pain, rotator cuff, meniscal tear, ankle sprain, limb pain, knee OA, weakness Physical Therapy
  • 97162 PT evaluation moderate complexity — same plus post-fracture, post-replacement, hemiplegia Physical Therapy
  • J7322 CMS LCD: Billing and Coding: Intraarticular Knee Injections of Hyaluronan CMS LCD
  • J7320 CMS LCD: Billing and Coding: Intraarticular Knee Injections of Hyaluronan CMS LCD

Convert M17.11 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M17.11 71516 10000

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

ICD-10 M17.11, Billing FAQ

Is ICD-10 code M17.11 billable? +

Yes, M17.11 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 M17.11? +

Procedures frequently paired with M17.11 include: 27447, 20610, 27447, 27446, 73721.

What ICD-9 codes does M17.11 map to? +

Per CMS GEMs, M17.11 maps to ICD-9 codes: 71516. 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 June 1, 2026.

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