M12.522
BillableTraumatic arthropathy, left elbow
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M12.522 an HCC code?
No. M12.522 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
M12.522 is the ICD-10-CM diagnosis code for traumatic arthropathy, left elbow. Joint damage and arthritis in the left elbow caused by a previous injury or trauma. M12.522 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).
M12.522 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify the documentation clearly states 'left' elbow to avoid miscoding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M12.522 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the documentation clearly states 'left' elbow to avoid miscoding
- •This code may be used for post-traumatic elbow arthritis developing after prior injury