Joint Pain (Arthralgia) ICD-10-CM codes

Joint pain is coded to M25.5- by joint and side. The 5th character is the joint (1 shoulder, 2 elbow, 3 wrist, 4 hand, 5 hip, 6 knee, 7 ankle and foot) and the 6th character is laterality (1 right, 2 left, 9 unspecified). Knee pain is the most common: M25.561 right, M25.562 left. M25.50 (pain in unspecified joint) should be rare, and M25.59 covers named joints without their own code such as the sacroiliac or temporomandibular joint (though TMJ pain has its own code in M26.6-).

M25.5- is for pain in a joint. Pain in a limb segment that is not a joint uses M79.6-: M79.601 right arm, M79.604 right leg, M79.641 right hand, M79.671 right foot, and so on. The Excludes2 note allows both a joint pain code and a limb pain code when both are documented. Other joint symptoms in M25 follow the same site and laterality scheme: M25.46- knee effusion, M25.66- knee stiffness, and M25.76- osteophyte.

Arthralgia is a symptom code and is not reported once the provider documents a definitive diagnosis for the same joint, such as M17.11 for right knee osteoarthritis or M23 for a meniscal derangement. Bilateral pain requires two codes, one for each side; there is no bilateral option in M25.5-. Arthralgia in a child with no cause found may also be reported this way, but juvenile arthritis (M08) requires a provider diagnosis.