FY2027 ICD-10-CM reference
M25.561: Pain in right knee
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Pain in right knee. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Source: M00-M99 (chapter, inherited).
Excludes2
arthropathic psoriasis (L40.5-)
Source: M00-M99 (chapter, inherited).
Excludes2
certain conditions originating in the perinatal period (P04-P96)
Source: M00-M99 (chapter, inherited).
Excludes2
certain infectious and parasitic diseases (A00-B99)
Source: M00-M99 (chapter, inherited).
Excludes2
compartment syndrome (traumatic) (T79.A-)
Source: M00-M99 (chapter, inherited).
Excludes2
complications of pregnancy, childbirth and the puerperium (O00-O9A)
Source: M00-M99 (chapter, inherited).
Excludes2
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
Source: M00-M99 (chapter, inherited).
Excludes2
endocrine, nutritional and metabolic diseases (E00-E88)
Source: M00-M99 (chapter, inherited).
Excludes2
injury, poisoning and certain other consequences of external causes (S00-T88)
Source: M00-M99 (chapter, inherited).
Excludes2
neoplasms (C00-D49)
Source: M00-M99 (chapter, inherited).
Excludes2
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Source: M00-M99 (chapter, inherited).
Excludes2
joints of the spine (M40-M54)
Source: M20-M25 (section, inherited).
Excludes2
abnormality of gait and mobility (R26.-)
Source: M25 (category, inherited).
Excludes2
acquired deformities of limb (M20-M21)
Source: M25 (category, inherited).
Excludes2
calcification of bursa (M71.4-)
Source: M25 (category, inherited).
Excludes2
calcification of shoulder (joint) (M75.3)
Source: M25 (category, inherited).
Excludes2
calcification of tendon (M65.2-)
Source: M25 (category, inherited).
Excludes2
difficulty in walking (R26.2)
Source: M25 (category, inherited).
Excludes2
temporomandibular joint disorder (M26.6-)
Source: M25 (category, inherited).
Excludes2
pain in hand (M79.64-)
Source: M25.5 (self, inherited).
Excludes2
pain in fingers (M79.64-)
Source: M25.5 (self, inherited).
Excludes2
pain in foot (M79.67-)
Source: M25.5 (self, inherited).
Excludes2
pain in limb (M79.6-)
Source: M25.5 (self, inherited).
Excludes2
pain in toes (M79.67-)
Source: M25.5 (self, inherited).
Compare the FY2027 additions, removals and billable-status changes
What does M25.561 mean in FY2027?
The official ICD-10-CM descriptor is Pain in right knee. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is M25.561 billable in FY2027?
The FY2027 order file marks M25.561 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does M25.561 map to an HCC?
M25.561 has no CMS-HCC V28 category in the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service). Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: no ESRD category; no RxHCC category. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: no category in the HHS-HCC 2026 benefit year mapping. CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). The PACE mapping is still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.
Review the FY2026 April edition