2025 ICD-10-CM code M77
Other enthesopathies. This code excludes bursitis NOS (M71.9-) and bursitis due to use, overuse and pressure (M70.-), osteophyte (M25.7), and spinal enthesopathy (M46.0-).
Medical necessity for using M77 must be supported by documentation of the signs and symptoms of enthesopathy, along with diagnostic testing confirming the condition and ruling out other specific types of enthesopathy. The documentation must also show how the enthesopathy affects the patient's function and quality of life.
Providers diagnose other enthesopathy based on patient history of pain, physical examination (including range of motion), imaging (X-rays, MRI, ultrasound), and lab studies (sedimentation rate, rheumatoid factor). Treatment involves pain relief and reducing inflammation through medications (analgesics, NSAIDs) and physical therapy to improve range of motion, strength, and flexibility.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Soft tissue disorders (M60-M79)
In simple words: Enthesopathy is a condition where the connections between your tendons or ligaments and bones become inflamed or painful. This code is used when the specific type of enthesopathy isn't covered by another code.It's like a general category for enthesopathies that are less common or not well-defined.
Other enthesopathy refers to a disorder that affects the site where ligaments, tendons, or muscles attach to the joint or bone, as the result of an inflammatory rheumatic or nonrheumatic disease.The provider identifies the type of enthesopathy; this code represents other specified enthesopathy not specifically named under any other codes.
Example 1: A patient presents with pain and stiffness in the elbow where the tendons attach to the bone. After examination and imaging, the provider diagnoses an enthesopathy not otherwise specified, and uses code M77., A patient experiences foot pain specifically at the attachment point of the Achilles tendon.Diagnostic imaging confirms enthesopathy, and in the absence of other specific diagnoses, M77 is used., A patient with a history of inflammatory arthritis develops pain and tenderness in multiple joints, particularly at the points where ligaments attach to the bones. The provider determines this to be an enthesopathy related to the underlying arthritis, but not a specific type already coded, and uses M77.
Documentation should include patient history of pain, location and characteristics of pain, physical exam findings including range of motion limitations, results of imaging studies (X-ray, MRI, ultrasound) and lab tests (if performed) such as sedimentation rate and rheumatoid factor to assess for underlying inflammatory conditions. The specific type of enthesopathy should be documented, and if no specific type can be identified, documentation justifying the use of "other" enthesopathy code M77 should be present.
** It is crucial to differentiate enthesopathy from other conditions like bursitis and osteophytes. Be sure to consult iFrameAI for additional resources on specific enthesopathy diagnoses and documentation best practices.
- Specialties:Rheumatology, Orthopedics, Sports Medicine, Physical Medicine and Rehabilitation
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Independent Clinic, Physical Therapy Office