M00.09 ICD-10-CM Code: Staphylococcal polyarthritis
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 1 Excludes2 · 1 use-additional code
- Risk adjustment
- CMS-HCC V28: 1 category · CMS-HCC V22 category 39
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 548 — SEPTIC ARTHRITIS WITH MCC (MDC 08)
- MS-DRG 549 — SEPTIC ARTHRITIS WITH CC (MDC 08)
- MS-DRG 550 — SEPTIC ARTHRITIS WITHOUT CC/MCC (MDC 08)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Risk Adjustment (CMS-HCC)
Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.
- HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
Other models: CMS-HCC V22 HCC 39
Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M00.09 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Notes without a marker are published on M00.09 itself; “inherited from” names the category or block whose note applies here.
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- infection and inflammatory reaction due to internal joint prosthesis (T84.5-) Compare M00.09 vs T84.5 →
Source: inherited from M00
Coder workflow for M00.09
MedCoder structured workflow — derived from this code’s own official record
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- The conditions the Use Additional Code note names
- Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.
Official instructions as workflow
Excludes2 — not part of M00.09(1 note)
Coding workflow: The conditions named in this note are not included in M00.09. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareT84.5
See the official tabular notes · Guidelines I.A.12.b
Use Additional Code — after identifying M00.09(1 note)
Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with M00.09 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.
See the official tabular notes · Guidelines I.A.13
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: A condition the Use Additional Code note names is documented.
Coding question: Is a second code reported with M00.09?
Path: Review the Use Additional Code note and the code it names.
Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Indexed Clinical Terms (1)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Verify Before Coding
- CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 938 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 3 MS-DRGs: DRG 548 (MDC 08), DRG 549 (MDC 08), DRG 550 (MDC 08).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):MUS001 — Infective arthritis (default); INF003 — Bacterial infections.
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same CMS-HCC risk category (V28)
CMS maps these diagnoses to the same Hierarchical Condition Category (Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis) for risk-adjusted payment.
M00.051 — Staphylococcal arthritis, right hip, M00.052 — Staphylococcal arthritis, left hip, M00.059 — Staphylococcal arthritis, unspecified hip, M00.061 — Staphylococcal arthritis, right knee, M00.062 — Staphylococcal arthritis, left knee, M00.069 — Staphylococcal arthritis, unspecified knee, M00.071 — Staphylococcal arthritis, right ankle and foot, M00.072 — Staphylococcal arthritis, left ankle and foot, M00.079 — Staphylococcal arthritis, unspecified ankle and foot, M00.08 — Staphylococcal arthritis, vertebrae, M00.10 — Pneumococcal arthritis, unspecified joint, M00.111 — Pneumococcal arthritis, right shoulder, M00.112 — Pneumococcal arthritis, left shoulder, M00.119 — Pneumococcal arthritis, unspecified shoulder, M00.121 — Pneumococcal arthritis, right elbow, M00.122 — Pneumococcal arthritis, left elbow, M00.129 — Pneumococcal arthritis, unspecified elbow, M00.131 — Pneumococcal arthritis, right wrist, M00.132 — Pneumococcal arthritis, left wrist, M00.139 — Pneumococcal arthritis, unspecified wrist, +588 more
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Infective arthritis, Bacterial infections).
M00.051 — Staphylococcal arthritis, right hip, M00.052 — Staphylococcal arthritis, left hip, M00.059 — Staphylococcal arthritis, unspecified hip, M00.061 — Staphylococcal arthritis, right knee, M00.062 — Staphylococcal arthritis, left knee, M00.069 — Staphylococcal arthritis, unspecified knee, M00.071 — Staphylococcal arthritis, right ankle and foot, M00.072 — Staphylococcal arthritis, left ankle and foot, M00.079 — Staphylococcal arthritis, unspecified ankle and foot, M00.08 — Staphylococcal arthritis, vertebrae, M00.10 — Pneumococcal arthritis, unspecified joint, M00.111 — Pneumococcal arthritis, right shoulder, M00.112 — Pneumococcal arthritis, left shoulder, M00.119 — Pneumococcal arthritis, unspecified shoulder, M00.121 — Pneumococcal arthritis, right elbow, M00.122 — Pneumococcal arthritis, left elbow, M00.129 — Pneumococcal arthritis, unspecified elbow, M00.131 — Pneumococcal arthritis, right wrist, M00.132 — Pneumococcal arthritis, left wrist, M00.139 — Pneumococcal arthritis, unspecified wrist, +411 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Arthritis, arthritic”; these codes share that main term but sit in a different category of the Tabular List.
E85.4 — Organ-limited amyloidosis (in, amyloidosis), E88.9 — Metabolic disorder, unspecified (in, metabolic disorder NEC), G95.0 — Syringomyelia and syringobulbia (in, syringomyelia), G98.0 — Neurogenic arthritis, not elsewhere classified (in, neurological disorder NEC), J98.9 — Respiratory disorder, unspecified (in, respiratory disorder NEC), L40.50 — Arthropathic psoriasis, unspecified (psoriatic), L40.52 — Psoriatic arthritis mutilans (mutilans), L40.54 — Psoriatic juvenile arthropathy (juvenile, psoriatic), L51.9 — Erythema multiforme, unspecified (in, erythema, multiforme), L52 — Erythema nodosum (in, erythema, nodosum), M04.1 — Periodic fever syndromes (in, Mediterranean fever, familial), M05.70 — Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement (rheumatoid, seropositive, without organ involvement), M05.71 — Rheumatoid arthritis with rheumatoid factor of shoulder without organ or systems involvement (rheumatoid, seropositive, without organ involvement, shoulder), M05.72 — Rheumatoid arthritis with rheumatoid factor of elbow without organ or systems involvement (rheumatoid, seropositive, without organ involvement, elbow), M05.73 — Rheumatoid arthritis with rheumatoid factor of wrist without organ or systems involvement (rheumatoid, seropositive, without organ involvement, wrist), M05.74 — Rheumatoid arthritis with rheumatoid factor of hand without organ or systems involvement (rheumatoid, seropositive, without organ involvement, hand joint), M05.75 — Rheumatoid arthritis with rheumatoid factor of hip without organ or systems involvement (rheumatoid, seropositive, without organ involvement, hip), M05.76 — Rheumatoid arthritis with rheumatoid factor of knee without organ or systems involvement (rheumatoid, seropositive, without organ involvement, knee), M05.77 — Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or systems involvement (rheumatoid, seropositive, without organ involvement, ankle), M05.79 — Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement (rheumatoid, seropositive, without organ involvement, multiple sites), +153 more
Contextual Map
Every relationship of M00.09 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00-M25 — Arthropathies[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00-M02 — Infectious arthropathies[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Clinical classification (CCSR)
- MUS001 — Infective arthritis[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
- INF003 — Bacterial infections[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
Risk adjustment (CMS-HCC)
- HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis [CMS-HCC]— CMS-HCC V28 · 2026
MS-DRG Grouper
- CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
- DRG 548 — SEPTIC ARTHRITIS WITH MCC[MS-DRG]: “SEPTIC ARTHRITIS WITH MCC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 549 — SEPTIC ARTHRITIS WITH CC[MS-DRG]: “SEPTIC ARTHRITIS WITH CC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 550 — SEPTIC ARTHRITIS WITHOUT CC/MCC[MS-DRG]: “SEPTIC ARTHRITIS WITHOUT CC/MCC (MDC 08)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue[MDC crossing]: “Diseases and Disorders of the Musculoskeletal System and Connective Tissue — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 18,508 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- Arthritis, arthritic (acute) (chronic) (nonpyogenic) (subacute), staphylococcal, multiple site[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (40)
- M00 — Pyogenic arthritis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00.031 — Staphylococcal arthritis, right wrist[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00.032 — Staphylococcal arthritis, left wrist[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00.039 — Staphylococcal arthritis, unspecified wrist[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00.04 — Staphylococcal arthritis, hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00.041 — Staphylococcal arthritis, right hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00.042 — Staphylococcal arthritis, left hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M00.049 — Staphylococcal arthritis, unspecified hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 32 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Risk adjustment Official source data
- 2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "M00.09 — Staphylococcal polyarthritis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/m00.09-staphylococcal-polyarthritis
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionStaphylococcal polyarthritis
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M00.09 in its code family, with their registry titles.
- M00.07 — Staphylococcal arthritis, ankle and foot
- M00.071 — Staphylococcal arthritis, right ankle and foot
- M00.072 — Staphylococcal arthritis, left ankle and foot
- M00.079 — Staphylococcal arthritis, unspecified ankle and foot
- M00.08 — Staphylococcal arthritis, vertebrae
- M00.1 — Pneumococcal arthritis and polyarthritis
- M00.10 — Pneumococcal arthritis, unspecified joint
- M00.11 — Pneumococcal arthritis, shoulder
- M00.111 — Pneumococcal arthritis, right shoulder
- M00.112 — Pneumococcal arthritis, left shoulder