M13.121: Monoarthritis, not elsewhere classified, right elbow
M13.121, monoarthritis, not elsewhere classified, right elbow, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 12 HCPCS Level II codes, including G0283 (Electrical stimulation (unattended), to one or more areas…), G0329 (Electromagnetic therapy, to one or more areas for chronic…), G0152 (Services performed by a qualified occupational therapist…). The articles come from 1 Medicare contractor. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M13.121 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0157 | Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0159 | Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2168 | Services performed by a physical therapist assistant in the home health setting in the delivery of a safe and effective physical therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| L1972 | Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf | Carrier judgment | — | 1 |
Medicare policy articles listing M13.121
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
- A53058: Billing and Coding: Home Health Physical Therapy (Palmetto GBA (HHH MAC); 6 Level II codes). LCD with the same title: L34564
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M13 diagnoses (Other arthritis)
- M13.122 — Monoarthritis, not elsewhere classified, left elbow
- M13.111 — Monoarthritis, not elsewhere classified, right shoulder
- M13.112 — Monoarthritis, not elsewhere classified, left shoulder
- M13.131 — Monoarthritis, not elsewhere classified, right wrist
- M13.132 — Monoarthritis, not elsewhere classified, left wrist
- M13.141 — Monoarthritis, not elsewhere classified, right hand
- M13.142 — Monoarthritis, not elsewhere classified, left hand
- M13.0 — Polyarthritis, unspecified
- M13.811 — Other specified arthritis, right shoulder
- M13.812 — Other specified arthritis, left shoulder
- M13.821 — Other specified arthritis, right elbow
- M13.822 — Other specified arthritis, left elbow
- M13.831 — Other specified arthritis, right wrist
- M13.832 — Other specified arthritis, left wrist
- M13.841 — Other specified arthritis, right hand
- M13.842 — Other specified arthritis, left hand
Frequently asked questions
Does Medicare cover M13.121 (Monoarthritis, not elsewhere classified, right elbow)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list M13.121 as a covered diagnosis for 12 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M13.121?
The Level II codes from the policies most specific to this diagnosis are G0283 (Electrical stimulation (unattended), to one or more areas…, 2 articles); G0329 (Electromagnetic therapy, to one or more areas for chronic…, 2 articles); G0152 (Services performed by a qualified occupational therapist…, 1 article); G0158 (Services performed by a qualified occupational therapist…, 1 article); G0160 (Services performed by a qualified occupational therapist…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M13.121?
A53057 (Billing and Coding: Home Health Occupational Therapy); A53064 (Billing and Coding: Outpatient Occupational Therapy); A53058 (Billing and Coding: Home Health Physical Therapy).
What is ICD-10-CM code M13.121?
M13.121 is the ICD-10-CM code for monoarthritis, not elsewhere classified, right elbow, in category M13 (Other arthritis), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0283
- Watch G0283 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0283
Compiled by Caduvo from public CMS (Medicare) records, ICD-10-CM FY2026, HCPCS release October 2026, 2026 fee schedule (non-rural state fees). Not reviewed or endorsed by CMS. Not billing or legal advice. Report an error. Data and corrections policy.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup