The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a crucial system for classifying diagnoses and health problems in medical coding. Within this system, Diagnosis Code M16.11 holds specific significance for healthcare providers and medical coders. This code precisely identifies unilateral primary osteoarthritis of the right hip.
M16.11 is recognized as a billable and specific code within the ICD-10-CM framework. This means it is valid for indicating a diagnosis in medical billing and reimbursement processes. The code officially came into effect on October 1, 2015, as part of the 2016 ICD-10-CM update, and remains current through the 2025 edition, effective October 1, 2024. It’s important to note that M16.11 is specific to the American ICD-10-CM version; international versions may have variations.
Several terms are considered approximate synonyms for diagnosis code M16.11, which can aid in understanding and identifying this condition. These include:
- Arthritis of right hip
- Osteoarthritis of right hip
- Primary localized osteoarthritis of right hip
- Primary osteoarthritis of right hip
Within the ICD-10-CM system, M16.11 is categorized under broader groups for osteoarthritis of the hip (M16) and unilateral primary osteoarthritis of the hip (M16.1). It’s also relevant to Diagnostic Related Groups (MS-DRG v42.0), which are used for hospital inpatient classifications.
The code history of M16.11 shows its stability and consistent use since its introduction in 2016. There have been no revisions or changes to this code from 2016 through the upcoming 2025 edition, indicating its established role in medical diagnosis coding.
Understanding diagnosis code M16.11 is essential for accurate medical coding, ensuring proper documentation and reimbursement for the diagnosis of unilateral primary osteoarthritis of the right hip. For further context, codes adjacent to M16.11 in the ICD-10-CM system relate to other forms of osteoarthritis, including those affecting other joints and different etiologies of hip osteoarthritis, such as dysplasia or post-traumatic conditions.
