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 left hip. As with the knee family, the unilateral codes (M16.11 right, M16.12 left) plus bilateral M16.0 give payers the specificity they expect on arthroplasty-bound pathways.
| Code | Description |
|---|---|
| M16.10 | Unilateral primary osteoarthritis, unspecified hip |
| M16.11 | Unilateral primary osteoarthritis, right 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 |
The operational risk with hip patients is the spine-versus-hip ambiguity: radiating leg pain that turns out to be lumbar, or buttock pain that is actually joint. Routing rules that ask about pain distribution on the phone put the patient in front of the right surgeon the first time.
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.
M16.12 is the FY2026 ICD-10-CM code for unilateral primary osteoarthritis, left hip. Primary osteoarthritis of the left hip.
When both hips show primary osteoarthritis. Bilateral disease takes the bilateral code, not stacked unilateral codes.
Yes. M16.12 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.
