M12.552
BillableTraumatic arthropathy, left hip
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M12.552 an HCC code?
No. M12.552 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
M12.552 is the ICD-10-CM diagnosis code for traumatic arthropathy, left hip. Joint damage in the left hip caused by trauma or injury, resulting in arthritis-like symptoms. M12.552 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).
M12.552 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 left hip is clearly documented in the clinical notes before assigning this code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M12.552 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify left hip is clearly documented in the clinical notes before assigning this code
- •Consider if this is a sequela of a previous injury that should be linked to the original trauma code