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

ICD-10 M26.69

Billable / Specific

Other specified disorders of temporomandibular joint

M26
Block
0
Synonyms
168
LCDs
7
Payer Policies
0
Linked CPTs

About ICD-10-CM M26.69

ICD-10-CM code M26.69 represents Other specified disorders of temporomandibular joint. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M26). The 2026 edition of ICD-10-CM M26.69 became effective on October 1, 2025.

Medicare LCD Coverage for M26.69

Local Coverage Determinations (LCDs) from CMS MACs that list M26.69 as a covered diagnosis.

168 LCDs

Showing top 10 of 168 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 M26.69.

7 policies

4 Aetna

Temporomandibular Disorders - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0028
Chiropractic Services
Policy ID: CPB-0107
Acupuncture and Dry Needling
Policy ID: CPB-0135
Jaw Motion Rehabilitation Systems
Policy ID: CPB-0412

3 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with M26.69

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

No procedure linkages on file for M26.69

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 M26.69 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M26.69 52460 10000
M26.69 52469 10000

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

ICD-10 M26.69, Billing FAQ

Is ICD-10 code M26.69 billable? +

Yes, M26.69 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does M26.69 map to? +

Per CMS GEMs, M26.69 maps to ICD-9 codes: 52460, 52469. 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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