ICDcodes.org
FY2027

M26.54 — Insufficient anterior guidance

Billable

Is M26.54 billable?

Yes — M26.54 is billable for FY2027. M26.54 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M26.54 may be submitted for encounters from October 1, 2026 through September 30, 2027.

M26.54 at a glance

CodeM26.54
DescriptionInsufficient anterior guidance
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Which MS-DRGs does M26.54 group to?

M26.54 sits in MDC Pre 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.

  • 011Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCCsurgical
  • 012Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CCsurgical
  • 013Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCCsurgical

How is M26.54 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to M26.54. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Guidance, insufficient anterior (occlusal)
  • Insufficiency, insufficient › anteriorguidance

Inclusion terms

Alternative wording in documentation that is classified to M26.54.

  • Insufficient anterior occlusal guidance

Excludes1 — never code together — inherited from M26-M27

The conditions below can never be reported together with M26.54 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • hemifacial atrophy or hypertrophy (Q67.4)
  • unilateral condylar hyperplasia or hypoplasia (M27.8)

Excludes1 — never code together — inherited from M26.5

The conditions below can never be reported together with M26.54 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

Excludes2 — not included here — inherited from Chapter 13

The conditions below are not part of M26.54, but a patient may have both at the same time. When documentation supports it, M26.54 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)

How long has M26.54 existed?

M26.54 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.

What other codes are in the M26.5 family? (8)