2027 ICD-10-CM Diagnosis Code M12.052Chronic postrheumatic arthropathy [Jaccoud], left hip
ICD-10-CM Codes›M00–M99›M05-M14›M12
- Billable — Valid for Submission
- Risk Adjusts — HCC 94
- Chronic Condition
M12.052 is a billable ICD-10-CM diagnosis code for chronic postrheumatic arthropathy [Jaccoud], left hip. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 553 through 554. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified chronic arthropathy.
For Medicare Advantage risk adjustment, M12.052 maps to CMS-HCC Category 94 (Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders) under the V28 model, adding a risk factor of about 0.268 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
M12.052 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M12.052: its own notes plus those printed at M12, block M00-M25, and Chapter 13. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- Disorders affecting predominantly peripheral (limb) joints
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may 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)
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, and stiffness in your joints. RA is an autoimmune disease. Although it is most common in the wrist and fingers, this disease can cause your immune system to attack any joint tissue. The inflammation (swelling) that comes with RA can also affect other body parts.
The full article covers:
- What is rheumatoid arthritis?
- Who is more likely to get rheumatoid arthritis?
- What causes rheumatoid arthritis?
- What are the symptoms of rheumatoid arthritis?
- How is rheumatoid arthritis diagnosed?
- What are the treatments for rheumatoid arthritis?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M12.052 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M12.052Overview
What is the ICD-10 code for chronic postrheumatic arthropathy [Jaccoud], left hip?
The ICD-10-CM code for chronic postrheumatic arthropathy [Jaccoud], left hip is M12.052 (sometimes written as M12052). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is M12.052 (Chronic postrheumatic arthropathy [Jaccoud], hip) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report chronic postrheumatic arthropathy [Jaccoud], left hip on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does M12.052 group to?
When chronic postrheumatic arthropathy [Jaccoud], left hip is the principal diagnosis on an inpatient stay, it groups to MS-DRG 554, 553, with relative weights from 0.8328 to 1.2492 depending on complications. Higher weights mean higher Medicare reimbursement.
Can M12.052 be reported with J38.7?
Not as a rule. The Excludes1 note at M12, which applies to M12.052, lists "cricoarytenoid arthropathy (J38.7)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of M12.052?
Under the General Equivalence Mappings, chronic postrheumatic arthropathy [Jaccoud], left hip converts to ICD-9-CM 714.4 (chr postrheum arthritis). The mapping is approximate, so confirm the match fits the documentation.
What HCC is M12.052?
M12.052 (chronic postrheumatic arthropathy [Jaccoud], left hip) maps to CMS-HCC Category 94 (Systemic Lupus Erythematosus and Other Specified Systemic Connective Tissue Disorders), commonly written as HCC 94, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 40 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 83.
Does M12.052 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, M12.052 adds a risk adjustment factor of about 0.268 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.196 to 0.297 depending on the payment segment). A more severe related category (HCC 93) supersedes it when both are reported. See the full factor table on the HCC 94 category page.
