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M16.11 vs M16.12

M16.11 (Unilateral primary osteoarthritis, right hip) compared with M16.12 (Unilateral primary osteoarthritis, left hip), from the official CMS tabular data. M16.11 and M16.12 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

M16.11
Right
Unilateral primary osteoarthritis, right hip
M16.12
Left
Unilateral primary osteoarthritis, left hip

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. M16.11 and M16.12 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

M16.11Unilateral primary osteoarthritis, right hipM16.12Unilateral primary osteoarthritis, left hip
Billing statusBillableBillable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionUnilateral primary osteoarthritis, right hip is a billable ICD-10-CM diagnosis code (M16.11).Unilateral primary osteoarthritis, left hip is a billable ICD-10-CM diagnosis code (M16.12).

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources