ICD-10 M75.4
Non-Billable HeaderImpingement syndrome of shoulder
About ICD-10-CM M75.4
ICD-10-CM code M75.4 represents Impingement syndrome of shoulder. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M75). The 2026 edition of ICD-10-CM M75.4 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Medicare LCD Coverage for M75.4
Local Coverage Determinations (LCDs) from CMS MACs that list M75.4 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M75.4.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M75.4 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
Codes Adjacent To M75.4
Other codes in section M70-M79 (Other soft tissue disorders).
ICD-10 M75.4, Billing FAQ
Is ICD-10 code M75.4 billable? +
No, M75.4 is a non-billable header code. Use a more specific child code from block M75 when submitting claims.
What CPT codes are commonly billed with M75.4? +
Procedures frequently paired with M75.4 include: 20680, 20600.
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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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