M60.029 — Infective myositis, unspecified upper arm
Is M60.029 billable?
Yes, but M60.029 will trip a Medicare edit. M60.029 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists M60.029 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
M60.029 at a glance
| Code | M60.029 |
|---|---|
| Description | Infective myositis, unspecified upper arm |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to M60.029?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M60.029 directly.
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 M60.029 group to?
M60.029 sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 557Tendonitis, Myositis and Bursitis with MCCmedical
- 558Tendonitis, Myositis and Bursitis without MCCmedical
As a secondary diagnosis, M60.029 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M60.029 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M60.02, the nearest indexed parent of M60.029. Use them to find the family, then select the specific code.
- Myositis › infective › upper limb › upper arm
Excludes1 — never code together — inherited from M60-M63
The conditions below can never be reported together with M60.029 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from M60.0
Report an additional code alongside M60.029 to fully describe the condition. M60.029 is sequenced first.
- code (B95-B97) to identify infectious agent
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M60.029, but a patient may have both at the same time. When documentation supports it, M60.029 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 M60-M63
The conditions below are not part of M60.029, but a patient may have both at the same time. When documentation supports it, M60.029 and the excluded code may both be reported.
- muscular dystrophies and myopathies (G71-G72)
Excludes2 — not included here — inherited from M60
The conditions below are not part of M60.029, but a patient may have both at the same time. When documentation supports it, M60.029 and the excluded code may both be reported.
- inclusion body myositis [IBM] (G72.41)
How long has M60.029 existed?
M60.029 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.