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

ICD-10 M53.1

Billable / Specific

Cervicobrachial syndrome

M53
Block
0
Synonyms
600
LCDs
20
Payer Policies
20
Linked CPTs

About ICD-10-CM M53.1

ICD-10-CM code M53.1 represents Cervicobrachial syndrome. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M53). The 2026 edition of ICD-10-CM M53.1 became effective on October 1, 2025.

Type 2 Excludes

Not included here, the excluded code is not part of M53.1, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • cervical disc disorder (M50.-)
  • thoracic outlet syndrome (G54.0)

Medicare LCD Coverage for M53.1

Local Coverage Determinations (LCDs) from CMS MACs that list M53.1 as a covered diagnosis.

600 LCDs

Showing top 10 of 600 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19300 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 15877 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19371 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19380 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30468 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30400 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19396 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30435 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30465 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30462 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M53.1.

20 policies

3 Aetna

Orthopedic Casts, Braces and Splints - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0009
Back Pain - Invasive Procedures - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0016
Intervertebral Disc Prostheses
Policy ID: CPB-0591

2 Cigna

Acupuncture - (CPG024)
Policy ID: CPG024_ACUPUNCTURE
Intraoperative Monitoring - (0509)
Policy ID: MM_0509

5 Medicare

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
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54095

CPT Codes Commonly Billed with M53.1

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

20 linkages
  • 22861 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 97171 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 97154 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 22858 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 97039 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 0098T CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 97139 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 97014 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 97156 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD
  • 97157 CMS LCD: Billing and Coding: Cervical Disc Replacement CMS LCD

Convert M53.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M53.1 7233 00000

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

ICD-10 M53.1, Billing FAQ

Is ICD-10 code M53.1 billable? +

Yes, M53.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 2 Excludes for M53.1? +

Type 2 Excludes (may be coded together when both conditions exist): cervical disc disorder (M50.-); thoracic outlet syndrome (G54.0)

What CPT codes are commonly billed with M53.1? +

Procedures frequently paired with M53.1 include: 22861, 97171, 97154, 22858, 97039.

What ICD-9 codes does M53.1 map to? +

Per CMS GEMs, M53.1 maps to ICD-9 codes: 7233. 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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