M13.129
BillableMonoarthritis, not elsewhere classified, unspecified elbow
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M13.129 an HCC code?
No. M13.129 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
M13.129 is the ICD-10-CM diagnosis code for monoarthritis, not elsewhere classified, unspecified elbow. Inflammation of a single joint in the elbow area when the specific side (right or left) is not documented. M13.129 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).
M13.129 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.
This code should be used sparingly; attempt to clarify laterality with provider documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M13.129 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code should be used sparingly; attempt to clarify laterality with provider documentation
- •Check if bilateral elbow involvement is present, which would require separate codes for each side