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M25.54 ICD-10-CM Code: Pain in joints of hand

Compare with another code for M25.54Check 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
13 Excludes2

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, and is marked with where it comes from.

Excludes2Not included here; may be reported together
  • pain in hand (M79.64-) (from M25.5)
  • pain in fingers (M79.64-) (from M25.5)
  • pain in foot (M79.67-) (from M25.5)
  • pain in limb (M79.6-) (from M25.5)

+9 more in Instructions

Where it sits Source: CMS/NCHS

Under:Chapter 13: Diseases of the Musculoskeletal System and Connective TissueM00-M25 ArthropathiesM20-M25 Other joint disordersM25 Other joint disorder, not elsewhere classifiedM25.5 Pain in joint

Codes under M25.54 (3)

  • M25.541Pain in joints of right handBillable
  • M25.542Pain in joints of left handBillable
  • M25.549Pain in joints of unspecified handBillable

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 M25.54 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 M25.54 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.

Coder workflow for M25.54

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

Before you code M25.54

  1. M25.54 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).

    ReviewM25.541, M25.542, M25.549

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

Choose the right path

  1. Does the documentation support one of the more specific codes beneath M25.54?
    Yes → Select that code and continue the checks below on its own page.
    No → M25.54 cannot be reported as written. Where the codes beneath it include an unspecified code, that code applies when the record goes no further; otherwise query for the missing detail.

    ReviewM25.541, M25.542, M25.549

Report the code beneath M25.54 that the documentation supports, not M25.54 itself. Then confirm that code is valid for the date of service on its own page.

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).

Official instructions as workflow

  • Excludes2 — not part of M25.54(13 notes)

    Coding workflow: The conditions named in this note are not included in M25.54. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareM79.64, M79.67, M79.6, R26, M71.4, M75.3

    See the official tabular notes · Guidelines I.A.12.b

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 M25.54 with…

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

The codes most likely to be picked instead of M25.54 — 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.

  • M25.50— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Pain in unspecified joint” takes M25.50; specificity in the record moves it back here.

    Full comparison: M25.54 vs M25.50 →

  • M79.64— 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 pain in hand adds M79.64; it is not part of this code and both may be reported when both are documented.

    Full comparison: M25.54 vs M79.64 →

  • M79.67— 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 pain in foot adds M79.67; it is not part of this code and both may be reported when both are documented.

    Full comparison: M25.54 vs M79.67 →

  • M79.6— 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 pain in hand adds M79.6; it is not part of this code and both may be reported when both are documented.

    Full comparison: M25.54 vs M79.6 →

  • R26— 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 abnormality of gait and mobility adds R26; it is not part of this code and both may be reported when both are documented.

    Full comparison: M25.54 vs R26 →

  • M20— 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 acquired deformities of limb adds M20; it is not part of this code and both may be reported when both are documented.

    Full comparison: M25.54 vs M20 →

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

Pain in joints of hand is a non-billable ICD-10-CM category code (M25.54). 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.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name M25.54 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: R52 — Pain, unspecified (via M25.5.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes across 2 chapters: G89 — Pain, not elsewhere classified (via M25.5.-), M79.6 — Pain in limb, hand, foot, fingers and toes (via M25.5.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Pain”; these codes share that main term but sit in a different category of the Tabular List.

G89.4 — Chronic pain syndrome (chronic, associated with significant psychosocial dysfunction), H57.1 — Ocular pain (ocular), I20.9 — Angina pectoris, unspecified (chest, ischemic), J34.89 — Other specified disorders of nose and nasal sinuses (nose), J39.2 — Other diseases of pharynx (pharynx), K08.89 — Other specified disorders of teeth and supporting structures (tooth), K13.79 — Other lesions of oral mucosa (mouth), K14.6 — Glossodynia (tongue), K62.89 — Other specified diseases of anus and rectum (anus), K82.9 — Disease of gallbladder, unspecified (gallbladder), M26.62 — Arthralgia of temporomandibular joint (temporomandibular), M53.1 — Cervicobrachial syndrome (cervicobrachial), M53.3 — Sacrococcygeal disorders, not elsewhere classified (coccyx), M54.14 — Radiculopathy, thoracic region (thoracic spine, with radicular and visceral pain), M54.2 — Cervicalgia (neck NEC), M54.4 — Lumbago with sciatica (spine, low back, with sciatica), M54.50 — Low back pain, unspecified (loin), M54.51 — Vertebrogenic low back pain (vertebrogenic, lumbar), M54.59 — Other low back pain (low back, specified NEC), M54.6 — Pain in thoracic spine (thoracic spine), +72 more

Contextual Map

Every relationship of M25.54 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.

Run M25.54 with these 3 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • R52 — Pain, unspecified[Excludes1](via M25.5.-): “joint pain (M25.5-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Excludes2 notes

Nearest codes (40)

Change history

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 M25.54 be billed directly?

No. M25.54 (Pain in joints of hand) 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 28, 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. "M25.54 — Pain in joints of hand." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/m25.54-pain-in-joints-of-hand

Change history

  • FY2017 — October 1, 2016
    Added to the code set
    Pain in joints of hand
    FY2017 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M25.54 in its code family, with their registry titles.

View all codes in the M25 family