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M67.412 ICD-10-CM Code: Ganglion, left shoulder

M67.412 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Disorders of synovium and tendon (M65-M67)

M67.412

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

Ganglion, left shoulder

A benign fluid-filled cyst that develops on the left shoulder, typically appearing as a small lump under the skin near the joint.

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
M67.4Ganglion
M67.41Ganglion, shoulder
M67.412Ganglion, left shoulder

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for M67.412 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for M67.412 in this effective period.

Related Child Codes

Official
M67.411Ganglion, right shoulder
M67.419Ganglion, unspecified shoulder

Includes

Official

ICD-10-CM does not list Includes notes for M67.412 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for M67.412 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for M67.412 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for M67.412 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for M67.412 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Verify laterality is documented as 'left' in the medical record before assigning this code
Ganglions are benign and typically don't require treatment unless they cause pain or functional impairment

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 M67.412 an HCC code?

No. M67.412 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Code
M67.412
Description
Ganglion, left shoulder
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
Yes
Payment year
2026

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

M67.412 is the ICD-10-CM diagnosis code for ganglion, left shoulder. A benign fluid-filled cyst that develops on the left shoulder, typically appearing as a small lump under the skin near the joint. M67.412 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering disorders of synovium and tendon (m65-m67).

M67.412 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28, V24, ESRD, or RxHCC 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 laterality is documented as 'left' in the medical record before assigning this code.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for M67.412 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Verify laterality is documented as 'left' in the medical record before assigning this code
  • Ganglions are benign and typically don't require treatment unless they cause pain or functional impairment

Child Codes

Code Hierarchy

Work M67.412 in HCC Buddy

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