ICDcodes.org
FY2027

M63.80 — Disorders of muscle in diseases classified elsewhere, unspecified site

BillableUnspecified

Is M63.80 billable?

Yes, but M63.80 is an unspecified code. M63.80 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M63.80 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting M63.80 — the more specific alternatives are listed below.

M63.80 at a glance

CodeM63.80
DescriptionDisorders of muscle in diseases classified elsewhere, unspecified site
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to M63.80?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M63.80 directly.

Manifestation code — never sequenced first — MCE edit 6

This code describes a manifestation of an underlying disease. The underlying condition must be sequenced before it, so it can never be the principal or first-listed diagnosis.

Which MS-DRGs does M63.80 group to?

M63.80 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

How is M63.80 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to M63.80. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Leprosy › with muscle disorder
  • Schistosomiasis › with muscle disorder
  • Trichinellosis, trichiniasis, trichinelliasis, trichinosis › with muscle disorder

Excludes1 — never code together — inherited from M60-M63

The conditions below can never be reported together with M63.80 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • dermatopolymyositis (M33.-)
  • myopathy in amyloidosis (E85.-)
  • myopathy in polyarteritis nodosa (M30.0)
  • myopathy in rheumatoid arthritis (M05.32)
  • myopathy in scleroderma (M34.-)
  • myopathy in Sjögren's syndrome (M35.03)
  • myopathy in systemic lupus erythematosus (M32.-)

Excludes1 — never code together — inherited from M63

The conditions below can never be reported together with M63.80 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • myopathy in cysticercosis (B69.81)
  • myopathy in endocrine diseases (G73.7)
  • myopathy in metabolic diseases (G73.7)
  • myopathy in sarcoidosis (D86.87)
  • myopathy in secondary syphilis (A51.49)
  • myopathy in syphilis (late) (A52.78)
  • myopathy in toxoplasmosis (B58.82)
  • myopathy in tuberculosis (A18.09)

Code first — inherited from M63

The underlying condition below must be sequenced before M63.80. M63.80 describes a manifestation and cannot be the principal or first-listed diagnosis.

Excludes2 — not included here — inherited from Chapter 13

The conditions below are not part of M63.80, but a patient may have both at the same time. When documentation supports it, M63.80 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 M63.80, but a patient may have both at the same time. When documentation supports it, M63.80 and the excluded code may both be reported.

  • muscular dystrophies and myopathies (G71-G72)

How long has M63.80 existed?

M63.80 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 M63.8 family? (9)