M65.012: Abscess of tendon sheath, left shoulder
M65.012, abscess of tendon sheath, left shoulder, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 8 HCPCS Level II codes, including G0283 (Electrical stimulation (unattended), to one or more areas…), G0152 (Services performed by a qualified occupational therapist…), G0158 (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 M65.012 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 |
| 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 |
| 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 | — | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 1 |
Medicare policy articles listing M65.012
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- 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
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 M65 diagnoses (Synovitis and tenosynovitis)
- M65.011 — Abscess of tendon sheath, right shoulder
- M65.021 — Abscess of tendon sheath, right upper arm
- M65.022 — Abscess of tendon sheath, left upper arm
- M65.031 — Abscess of tendon sheath, right forearm
- M65.032 — Abscess of tendon sheath, left forearm
- M65.041 — Abscess of tendon sheath, right hand
- M65.042 — Abscess of tendon sheath, left hand
- M65.051 — Abscess of tendon sheath, right thigh
- M65.052 — Abscess of tendon sheath, left thigh
- M65.061 — Abscess of tendon sheath, right lower leg
- M65.062 — Abscess of tendon sheath, left lower leg
- M65.071 — Abscess of tendon sheath, right ankle and foot
- M65.072 — Abscess of tendon sheath, left ankle and foot
- M65.08 — Abscess of tendon sheath, other site
- M65.311 — Trigger thumb, right thumb
- M65.312 — Trigger thumb, left thumb
- M65.321 — Trigger finger, right index finger
- M65.322 — Trigger finger, left index finger
- M65.331 — Trigger finger, right middle finger
- M65.332 — Trigger finger, left middle finger
- M65.341 — Trigger finger, right ring finger
- M65.342 — Trigger finger, left ring finger
- M65.351 — Trigger finger, right little finger
- M65.352 — Trigger finger, left little finger
- M65.4 — Radial styloid tenosynovitis [de Quervain]
- M65.831 — Other synovitis and tenosynovitis, right forearm
- M65.832 — Other synovitis and tenosynovitis, left forearm
- M65.841 — Other synovitis and tenosynovitis, right hand
- M65.842 — Other synovitis and tenosynovitis, left hand
- M65.90 — Unspecified synovitis and tenosynovitis, unspecified site
Frequently asked questions
Does Medicare cover M65.012 (Abscess of tendon sheath, left shoulder)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list M65.012 as a covered diagnosis for 8 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 M65.012?
The Level II codes from the policies most specific to this diagnosis are G0283 (Electrical stimulation (unattended), to one or more areas…, 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); G2169 (Services performed by an occupational therapist assistant…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M65.012?
A56619 (Billing and Coding: Nerve Conduction Studies and Electromyography); A53057 (Billing and Coding: Home Health Occupational Therapy); A53064 (Billing and Coding: Outpatient Occupational Therapy).
What is ICD-10-CM code M65.012?
M65.012 is the ICD-10-CM code for abscess of tendon sheath, left shoulder, in category M65 (Synovitis and tenosynovitis), 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
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup