ICD-10 M79
Non-Billable HeaderOther and unspecified soft tissue disorders, not elsewhere classified
About ICD-10-CM M79
ICD-10-CM code M79 represents Other and unspecified soft tissue disorders, not elsewhere classified. This is a non-billable header code in the Musculoskeletal and Connective Tissue chapter (block M79). The 2026 edition of ICD-10-CM M79 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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with M79. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- psychogenic rheumatism (F45.8)
- soft tissue pain, psychogenic (F45.41)
Medicare LCD Coverage for M79
Local Coverage Determinations (LCDs) from CMS MACs that list M79 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 M79.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but M79 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with M79
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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.
Codes Adjacent To M79
Other codes in section M70-M79 (Other soft tissue disorders).
ICD-10 M79, Billing FAQ
Is ICD-10 code M79 billable? +
No, M79 is a non-billable header code. Use a more specific child code from block M79 when submitting claims.
What codes are Type 1 Excludes for M79? +
Type 1 Excludes (never code together with M79): psychogenic rheumatism (F45.8); soft tissue pain, psychogenic (F45.41)
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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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