M25.529 ICD-10-CM Code: Pain in unspecified elbow
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other joint disorders (M20-M25)
M25.529
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePain in unspecified elbow
Elbow pain when the specific elbow (right or left) is not documented or both elbows are affected.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M25.529 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M25.529 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M25.529 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M25.529 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M25.529 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M25.529 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M25.529 in this effective period.
Buddy Documentation Tip
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.
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.
Coder workflow notes
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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.