M79.0
BillableRheumatism, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M79.0 an HCC code?
No. M79.0 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
M79.0 is the ICD-10-CM diagnosis code for rheumatism, unspecified. General muscle and joint pain or stiffness that cannot be attributed to a specific condition or location. M79.0 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering other soft tissue disorders (m70-m79).
M79.0 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; attempt to identify the underlying cause or location before assigning.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M79.0 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; attempt to identify the underlying cause or location before assigning
- •Review clinical notes for any clues about the source of rheumatism