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M25.52 ICD-10-CM Code: Pain in elbow

ICD-10-CM Code View

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

M25.52

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

Pain in elbow

Pain in elbow

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
M25Other joint disorder, not elsewhere classified
M25.5Pain in joint
M25.52Pain in elbow

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M25.52 in this effective period.

Excludes 2

Official
  • pain in hand (M79.64-)
  • pain in fingers (M79.64-)
  • pain in foot (M79.67-)
  • pain in limb (M79.6-)
  • pain in toes (M79.67-)

Related Child Codes

Official
M25.521Pain in right elbow
M25.522Pain in left elbow
M25.529Pain in unspecified elbow

Includes

Official

ICD-10-CM does not list Includes notes for M25.52 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M25.52 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M25.52 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M25.52 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M25.52 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

M25.52 is the ICD-10-CM diagnosis code for pain in elbow. M25.52 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).

Header codes like M25.52 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 M25.52'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 M25.52 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

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