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M25.59 ICD-10-CM Code: Pain in other specified joint

Compare with another code for M25.59Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Official instructions
13 Excludes2

What these terms mean →

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

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

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

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 v44, Appendix B.

  • MS-DRG 555 — SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC (MDC 08)
  • MS-DRG 556 — SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT 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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M25.59 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 M25.59 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 M25.59

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

Before you code M25.59

  1. “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 M25.59; 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).

    ReviewM25.53, M25.54, M25.55, M25.56, M25.57

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

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

Official instructions as workflow

  • Excludes2 — not part of M25.59(13 notes)

    Coding workflow: The conditions named in this note are not included in M25.59. 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 M25.59 with…

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

The codes most likely to be picked instead of M25.59 — 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.

  • 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: M25.59 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: M25.59 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: M25.59 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: M25.59 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: M25.59 vs M20 →

  • M21— 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 M21; it is not part of this code and both may be reported when both are documented.

    Full comparison: M25.59 vs M21 →

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 other specified joint is a billable ICD-10-CM diagnosis code (M25.59).

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

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 M25.59 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.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 555 (MDC 08), DRG 556 (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):MUS010 — Musculoskeletal pain, not low back pain (default).

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 clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Musculoskeletal pain, not low back pain).

M25.549 — Pain in joints of unspecified hand, M25.551 — Pain in right hip, M25.552 — Pain in left hip, M25.559 — Pain in unspecified hip, M25.561 — Pain in right knee, M25.562 — Pain in left knee, M25.569 — Pain in unspecified knee, M25.571 — Pain in right ankle and joints of right foot, M25.572 — Pain in left ankle and joints of left foot, M25.579 — Pain in unspecified ankle and joints of unspecified foot, M25.60 — Stiffness of unspecified joint, not elsewhere classified, M25.611 — Stiffness of right shoulder, not elsewhere classified, M25.612 — Stiffness of left shoulder, not elsewhere classified, M25.619 — Stiffness of unspecified shoulder, not elsewhere classified, M25.621 — Stiffness of right elbow, not elsewhere classified, M25.622 — Stiffness of left elbow, not elsewhere classified, M25.629 — Stiffness of unspecified elbow, not elsewhere classified, M25.631 — Stiffness of right wrist, not elsewhere classified, M25.632 — Stiffness of left wrist, not elsewhere classified, M25.639 — Stiffness of unspecified wrist, not elsewhere classified, +68 more

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

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of M25.59 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 M25.59 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

Clinical classification (CCSR)

MS-DRG Grouper

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. 18,439 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Pain (s), joint, specified site NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

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.

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.

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
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 — v44 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. "M25.59 — Pain in other specified joint." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/m25.59-pain-in-other-specified-joint

Change history

  • FY2021 — October 1, 2020
    Added to the code set
    Pain in other specified joint
    FY2021 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M25.59 in its code family, with their registry titles.

View all codes in the M25 family