Question 1

What is ICD-10 code M75?

Accepted Answer

M75 is the ICD-10-CM diagnosis code for Shoulder lesions. It belongs to the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99). M75 is a non-billable header code that organizes more specific child codes; the actual diagnosis on a claim must use one of those children. M75 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Question 2

Is M75 an HCC code?

Accepted Answer

M75 is a non-billable header code, so it cannot itself be a payment HCC. Header codes organize more specific child codes that share the same root concept; one of those children may map to a payment HCC under the CMS-HCC V28 or V24 risk adjustment model. Coders should select a child code from the M75 hierarchy that matches the documented presentation, then check that specific child for HCC status.

Question 3

Is M75 billable?

Accepted Answer

No. M75 is a header (non-billable) ICD-10-CM code. Header codes sit at a higher level of the diagnosis hierarchy and exist to organize a family of more specific child codes. Per ICD-10-CM coding guidelines, a header code cannot be reported on a claim as the diagnosis, coders must select a billable child code from the M75 hierarchy that matches the highest level of specificity supported by the provider's documentation. Payers reject header codes submitted as the primary diagnosis.

HCC Buddy Code Card

M75

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Excludes 2, Not included here, may code separately

Child Codes

Code Hierarchy

Work M75 in HCC Buddy

M75 ICD-10-CM Code: Shoulder lesions