Billable FY2026 ICD-10-CM diagnosis code, hip region. What it covers, how to bill it cleanly, and what these patients sound like when they call.
Primary osteoarthritis of the right hip: the hip-replacement pipeline's equivalent of M17.11. Primary indicates degenerative disease without an identified secondary cause such as prior trauma or dysplasia, and laterality is expected on the claim.
| Code | Description |
|---|---|
| M16.10 | Unilateral primary osteoarthritis, unspecified hip |
| M16.12 | Unilateral primary osteoarthritis, left hip |
| M16.0 | Bilateral primary osteoarthritis of hip |
| M16.2 | Bilateral osteoarthritis resulting from hip dysplasia |
| M16.30 | Unilateral osteoarthritis resulting from hip dysplasia, unspecified hip |
| M16.31 | Unilateral osteoarthritis resulting from hip dysplasia, right hip |
Hip arthritis callers describe groin pain, trouble with shoes and socks, and sleep interrupted by position changes. They route to the joint replacement team, and because hip pain masquerades (back, buttock, knee), good intake notes on pain location save a misrouted first visit.
ClinicFlow's voice AI runs this intake on every call for joint replacement practices: capturing the story, applying your routing rules, and booking the right visit type with the right surgeon. See voice AI for joint replacement practices or the Call Library for how each call type is handled.
M16.11 is the FY2026 ICD-10-CM code for unilateral primary osteoarthritis, right hip. Primary osteoarthritis of the right hip: the hip-replacement pipeline's equivalent of M17.
It matters for the differential. True hip joint arthritis classically presents with groin pain; buttock-dominant pain often implicates the spine, which changes both the specialist and the eventual code.
Yes. M16.11 appears in the official FY2026 ICD-10-CM code set (effective October 1, 2025). ICD-10-CM is public-domain CMS data; verify annually as codes are revised each fiscal year.
ClinicFlow answers all of them, 24/7, and books them with the right surgeon.
