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M00.26 ICD-10-CM Code: Other streptococcal arthritis, knee

Compare with another codeCheck this code on a claim

Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
1 Excludes2 · 1 use-additional code

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Use additional codeReport with this code when documented
  • code (B95.0-B95.2, B95.4-B95.5) to identify bacterial agent
Excludes2Not included here; may be reported together
  • infection and inflammatory reaction due to internal joint prosthesis (T84.5-)

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M00.26 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on M00.26 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.

Source: inherited from M00

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code (B95.0-B95.2, B95.4-B95.5) to identify bacterial agent
    B95.0-B95.2: B95.0, B95.1, B95.2B95.4-B95.5: B95.4, B95.5

Source: inherited from M00.2

Coder workflow for M00.26

MedCoder structured workflow — derived from this code’s own official record

Before you code M00.26

  1. M00.26 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewM00.261, M00.262, M00.269

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on M00.26; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath M00.26?
    Yes → Select that code and continue the checks below on its own page.
    No → M00.26 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewM00.261, M00.262, M00.269

Consider M00.26. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

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.
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes2 — not part of M00.26(1 note)

    Coding workflow: The conditions named in this note are not included in M00.26. 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 M00.26(1 note)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with M00.26 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 M00.26?

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.

Don’t confuse M00.26 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of M00.26 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • T84.5— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of infection and inflammatory reaction due to internal joint prosthesis adds T84.5; it is not part of this code and both may be reported when both are documented.

    Full comparison: M00.26 vs T84.5 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Other streptococcal arthritis, knee is a non-billable ICD-10-CM category code (M00.26). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Related Codes

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 M00.26 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

Nearest codes (40)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Common coding questions

MedCoder editorial

Can M00.26 be billed directly?

No. M00.26 (Other streptococcal arthritis, knee) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "M00.26 — Other streptococcal arthritis, knee." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/m00.26-other-streptococcal-arthritis-knee

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other streptococcal arthritis, knee

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 M00.26 in its code family, with their registry titles.

View all codes in the M00 family