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

ICD-10 M25.50

Billable / Specific

Pain in unspecified joint

M25
Block
0
Synonyms
107
LCDs
10
Payer Policies
9
Linked CPTs

About ICD-10-CM M25.50

ICD-10-CM code M25.50 represents Pain in unspecified joint. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M25). The 2026 edition of ICD-10-CM M25.50 became effective on October 1, 2025.

Medicare LCD Coverage for M25.50

Local Coverage Determinations (LCDs) from CMS MACs that list M25.50 as a covered diagnosis.

107 LCDs

Showing top 10 of 107 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0480 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0481 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0482 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0483 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80305 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT G0659 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80307 →
CMS LCD: Billing and Coding: Urine Drug Testing
Article ID: 59416, Effective: 2025-11-01 00:00:00, 428 covered, 0 non-covered
CPT 80306 →
CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85651 →
CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85652 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M25.50.

10 policies

1 Cigna

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP

5 Medicare

Billing and Coding: Urine Drug Testing
Policy ID: ART-54799
Billing and Coding: Urine Drug Testing
Policy ID: ART-55001
Billing and Coding: Zika Virus Testing by PCR and ELISA Methods
Policy ID: ART-55326
Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
Policy ID: ART-56645
Billing and Coding: Urine Drug Testing
Policy ID: ART-56818

CPT Codes Commonly Billed with M25.50

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

9 linkages
  • 20610 Joint injection — joint pain, arthritis, gout Orthopaedic Surgery
  • 99213 Established patient — HTN follow-up, diabetes management, hyperlipidemia, asthma, anxiety, common complaints, back pain, GERD, migraine, acne, joint pain, prediabetes, obesity, anemia, hypothyroid, fatigue Primary Care
  • 20610 Joint injection major — knee OA, hip OA, shoulder OA, shoulder impingement, joint pain, meniscal derangement, synovitis, bursitis 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
  • 97140 Manual therapy — back pain, neck pain, joint pain, myalgia, spasm, muscle weakness, impingement, somatic dysfunction, chronic pain, spondylosis Physical Therapy
  • 97035 Ultrasound therapy — myalgia, spasm, back pain, neck pain, joint pain, impingement, epicondylitis, plantar fasciitis 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
  • 86790 CMS LCD: Billing and Coding: Zika Virus Testing by PCR and ELISA Methods CMS LCD
  • 86794 CMS LCD: Billing and Coding: Zika Virus Testing by PCR and ELISA Methods CMS LCD

Convert M25.50 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M25.50 71940 10000

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

ICD-10 M25.50, Billing FAQ

Is ICD-10 code M25.50 billable? +

Yes, M25.50 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 M25.50? +

Procedures frequently paired with M25.50 include: 20610, 99213, 20610, 97110, 97140.

What ICD-9 codes does M25.50 map to? +

Per CMS GEMs, M25.50 maps to ICD-9 codes: 71940. 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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