What is ICD-10 code M25.512?

M25.512 is the ICD-10-CM diagnosis code for Pain in left shoulder. Pain in the left shoulder joint. It belongs to the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99). M25.512 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. M25.512 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. M25.512 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. M25.512 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does M25.512 map to under V28?

M25.512 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for M25.512?

M25.512 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for M25.512?

M25.512 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

What documentation supports M25.512?

Verify the medical record specifically documents left shoulder pain Note if pain is related to a specific shoulder structure or is generalized joint pain M25.512 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

2026 ICD-10-CM M25.512: Pain in left shoulder

M25.512 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupM25.512

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other joint disorders (M20-M25)

M25.512

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Pain in left shoulder

Pain in the left shoulder joint.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

M25.5Pain in joint M25.51Pain in shoulder M25.512Pain in left shoulder

Inclusion Terms

Official

No inclusion terms are included in this display for M25.512. Check the code and parent instructions in the Code Book.

Excludes 2

Official

arthropathic psoriasis (L40.5-)Inherited from M00-M99, M20-M25, M25, M25.5
certain conditions originating in the perinatal period (P04-P96)Inherited from M00-M99, M20-M25, M25, M25.5
certain infectious and parasitic diseases (A00-B99)Inherited from M00-M99, M20-M25, M25, M25.5
compartment syndrome (traumatic) (T79.A-)Inherited from M00-M99, M20-M25, M25, M25.5
complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from M00-M99, M20-M25, M25, M25.5
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)Inherited from M00-M99, M20-M25, M25, M25.5
endocrine, nutritional and metabolic diseases (E00-E88)Inherited from M00-M99, M20-M25, M25, M25.5
injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from M00-M99, M20-M25, M25, M25.5
neoplasms (C00-D49)Inherited from M00-M99, M20-M25, M25, M25.5
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from M00-M99, M20-M25, M25, M25.5
joints of the spine (M40-M54)Inherited from M00-M99, M20-M25, M25, M25.5
abnormality of gait and mobility (R26.-)Inherited from M00-M99, M20-M25, M25, M25.5
acquired deformities of limb (M20-M21)Inherited from M00-M99, M20-M25, M25, M25.5
calcification of bursa (M71.4-)Inherited from M00-M99, M20-M25, M25, M25.5
calcification of shoulder (joint) (M75.3)Inherited from M00-M99, M20-M25, M25, M25.5
calcification of tendon (M65.2-)Inherited from M00-M99, M20-M25, M25, M25.5
difficulty in walking (R26.2)Inherited from M00-M99, M20-M25, M25, M25.5
temporomandibular joint disorder (M26.6-)Inherited from M00-M99, M20-M25, M25, M25.5
pain in hand (M79.64-)Inherited from M00-M99, M20-M25, M25, M25.5
pain in fingers (M79.64-)Inherited from M00-M99, M20-M25, M25, M25.5
pain in foot (M79.67-)Inherited from M00-M99, M20-M25, M25, M25.5
pain in limb (M79.6-)Inherited from M00-M99, M20-M25, M25, M25.5
pain in toes (M79.67-)Inherited from M00-M99, M20-M25, M25, M25.5

Related Codes

Official

M25.511Pain in right shoulder M25.519Pain in unspecified shoulder

Includes

Official

No Includes notes are included in this display for M25.512. Check the code and parent instructions in the Code Book.

Excludes 1

Official

No Excludes 1 notes are included in this display for M25.512. Check the code and parent instructions in the Code Book.

Code First

Official

No Code First sequencing instructions are included in this display for M25.512. Check the code and parent instructions in the Code Book.

Use Additional

Official

No Use Additional Code instructions are included in this display for M25.512. Check the code and parent instructions in the Code Book.

Code Also

Official

No Code Also instructions are included in this display for M25.512. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify the medical record specifically documents left shoulder pain

Note if pain is related to a specific shoulder structure or is generalized joint pain

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 →

Is M25.512 an HCC code?

No. M25.512 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: M25.512
Description: Pain in left shoulder
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

M25.512 is the ICD-10-CM diagnosis code for pain in left shoulder. Pain in the left shoulder joint. M25.512 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering other joint disorders (m20-m25).

M25.512 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify the medical record specifically documents left shoulder pain.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for M25.512 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the medical record specifically documents left shoulder pain
•Note if pain is related to a specific shoulder structure or is generalized joint pain