2022 ICD-10-CM Code M25.4

Effusion of joint

Version 2021

Not Valid for Submission

Short Description:Effusion of joint
Long Description:Effusion of joint

Code Classification

  • Diseases of the musculoskeletal system and connective tissue (M00–M99)
    • Other joint disorders (M20-M25)
      • Other joint disorder, not elsewhere classified (M25)

M25.4 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of effusion of joint. The code is not specific and is NOT valid for the year 2022 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding for Effusion of joint

Non-specific codes like M25.4 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for effusion of joint:

  • BILLABLE CODE - Use M25.40 for Effusion, unspecified joint
  • NON-BILLABLE CODE - M25.41 for Effusion, shoulder
  • BILLABLE CODE - Use M25.411 for Effusion, right shoulder
  • BILLABLE CODE - Use M25.412 for Effusion, left shoulder
  • BILLABLE CODE - Use M25.419 for Effusion, unspecified shoulder
  • NON-BILLABLE CODE - M25.42 for Effusion, elbow
  • BILLABLE CODE - Use M25.421 for Effusion, right elbow
  • BILLABLE CODE - Use M25.422 for Effusion, left elbow
  • BILLABLE CODE - Use M25.429 for Effusion, unspecified elbow
  • NON-BILLABLE CODE - M25.43 for Effusion, wrist
  • BILLABLE CODE - Use M25.431 for Effusion, right wrist
  • BILLABLE CODE - Use M25.432 for Effusion, left wrist
  • BILLABLE CODE - Use M25.439 for Effusion, unspecified wrist
  • NON-BILLABLE CODE - M25.44 for Effusion, hand
  • BILLABLE CODE - Use M25.441 for Effusion, right hand
  • BILLABLE CODE - Use M25.442 for Effusion, left hand
  • BILLABLE CODE - Use M25.449 for Effusion, unspecified hand
  • NON-BILLABLE CODE - M25.45 for Effusion, hip
  • BILLABLE CODE - Use M25.451 for Effusion, right hip
  • BILLABLE CODE - Use M25.452 for Effusion, left hip
  • BILLABLE CODE - Use M25.459 for Effusion, unspecified hip
  • NON-BILLABLE CODE - M25.46 for Effusion, knee
  • BILLABLE CODE - Use M25.461 for Effusion, right knee
  • BILLABLE CODE - Use M25.462 for Effusion, left knee
  • BILLABLE CODE - Use M25.469 for Effusion, unspecified knee
  • NON-BILLABLE CODE - M25.47 for Effusion, ankle and foot
  • BILLABLE CODE - Use M25.471 for Effusion, right ankle
  • BILLABLE CODE - Use M25.472 for Effusion, left ankle
  • BILLABLE CODE - Use M25.473 for Effusion, unspecified ankle
  • BILLABLE CODE - Use M25.474 for Effusion, right foot
  • BILLABLE CODE - Use M25.475 for Effusion, left foot
  • BILLABLE CODE - Use M25.476 for Effusion, unspecified foot
  • BILLABLE CODE - Use M25.48 for Effusion, other site

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code M25.4:

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

Information for Patients

Joint Disorders

A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including

Treatment of joint problems depends on the cause. If you have a sports injury, treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery. For arthritis, injuries, or other diseases, you may need joint replacement surgery to remove the damaged joint and put in a new one.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

[Learn More in MedlinePlus]

Code History

  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)