M00.10 — Pneumococcal arthritis, unspecified joint

BillableUnspecifiedCC

Is M00.10 billable?

Yes, but M00.10 will trip a Medicare edit. M00.10 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists M00.10 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.

More specific alternatives

M00.10 at a glance

Code	M00.10
Description	Pneumococcal arthritis, unspecified joint
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to M00.10?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M00.10 directly.

Unspecified — a laterality-specific code exists — MCE edit 20

A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.

Which MS-DRGs does M00.10 group to?

M00.10 sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

548Septic Arthritis with MCCmedical
549Septic Arthritis with CCmedical
550Septic Arthritis without CC/MCCmedical

As a secondary diagnosis, M00.10 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is M00.10 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to M00.10. They show the wording a clinician may have documented, which often differs from the Tabular description.

Arthritis, arthritic › pneumococcal (acute) (chronic) (nonpyogenic) (subacute)

Excludes2 — not included here — inherited from Chapter 13

The conditions below are not part of M00.10, but a patient may have both at the same time. When documentation supports it, M00.10 and the excluded code may both be reported.

arthropathic psoriasis (L40.5-)
certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
compartment syndrome (traumatic) (T79.A-)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Excludes2 — not included here — inherited from M00

The conditions below are not part of M00.10, but a patient may have both at the same time. When documentation supports it, M00.10 and the excluded code may both be reported.

infection and inflammatory reaction due to internal joint prosthesis (T84.5-)

How long has M00.10 existed?

M00.10 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.

Which conditions are coded to M00.10?

ICD-10 code for Arthritis