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M07 ICD-10-CM Code: Enteropathic arthropathies

M07 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Inflammatory polyarthropathies (M05-M14)

M07

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Enteropathic arthropathies

Enteropathic arthropathies

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
M0Inflammatory polyarthropathies (M05-M14)
M07Enteropathic arthropathies

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M07 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M07 in this effective period.

Related Child Codes

Official
M07.6Enteropathic arthropathies

Includes

Official

ICD-10-CM does not list Includes notes for M07 in this effective period.

Excludes 1

Official
  • psoriatic arthropathies (L40.5-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M07 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M07 in this effective period.

Code Also

Official
  • associated enteropathy, such as:
  • regional enteritis [Crohn's disease] (K50.-)
  • ulcerative colitis (K51.-)

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
M07
Description
Enteropathic arthropathies
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

M07 is the ICD-10-CM diagnosis code for enteropathic arthropathies. M07 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering inflammatory polyarthropathies (m05-m14).

Header codes like M07 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at M07's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M07 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • psoriatic arthropathies (L40.5-)

Code Also

  • associated enteropathy, such as:
  • regional enteritis [Crohn's disease] (K50.-)
  • ulcerative colitis (K51.-)

Child Codes

Code Hierarchy

M07Enteropathic arthropathies
M07Enteropathic arthropathies

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