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M25.529

Billable

Pain in unspecified elbow

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is M25.529 an HCC code?

No. M25.529 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

M25.529 is the ICD-10-CM diagnosis code for pain in unspecified elbow. Elbow pain when the specific elbow (right or left) is not documented or both elbows are affected. M25.529 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).

M25.529 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 is a non-specific code; query the provider to determine laterality if possible.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M25.529 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This is a non-specific code; query the provider to determine laterality if possible
  • If bilateral elbow pain is documented, code both M25.521 and M25.522

Code Hierarchy

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