M94.219 — Chondromalacia, unspecified shoulder
Is M94.219 billable?
Yes, but M94.219 is an unspecified code. M94.219 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, M94.219 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 M94.219 — the more specific alternatives are listed below.
More specific alternatives
M94.219 at a glance
| Code | M94.219 |
|---|---|
| Description | Chondromalacia, unspecified shoulder |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does M94.219 group to?
M94.219 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.
- 553Bone Diseases and Arthropathies with MCCmedical
- 554Bone Diseases and Arthropathies without MCCmedical
How is M94.219 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M94.21, the nearest indexed parent of M94.219. Use them to find the family, then select the specific code.
- Chondromalacia › acromioclavicular joint (systemic)
- Chondromalacia › glenohumeral joint (systemic)
- Chondromalacia › shoulder (systemic)
- Chondromalacia › sternoclavicular joint (systemic)
Excludes1 — never code together — inherited from M91-M94
The conditions below can never be reported together with M94.219 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- postprocedural chondropathies (M96.-)
Excludes1 — never code together — inherited from M94.2
The conditions below can never be reported together with M94.219 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- chondromalacia patellae (M22.4)
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M94.219, but a patient may have both at the same time. When documentation supports it, M94.219 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 M94.219 existed?
M94.219 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.