RTM · Orthopedics
RTM Qualifying Diagnoses
for Orthopedics.
164 ICD-10-CM codes cover orthopedics patients for Remote Therapeutic Monitoring (RTM).
Qualifying Codes
ICD-10 codes for orthopedics.
Musculoskeletal and pain
Osteoarthritis
M15, M16, M17, M18, M1998 codesrtmccmPain scores, range of motion and home-exercise adherence. This is the core RTM use case.
Osteoarthritis
M15, M16, M17, M18, M1998 codesrtmccmCMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| M15.0 | Primary generalized (osteo)arthritis | rtmccm | not risk adjusted |
| M15.1 | Heberden's nodes (with arthropathy) | rtmccm | not risk adjusted |
| M15.2 | Bouchard's nodes (with arthropathy) | rtmccm | not risk adjusted |
| M15.3 | Secondary multiple arthritis | rtmccm | not risk adjusted |
| M15.4 | Erosive (osteo)arthritis | rtmccm | not risk adjusted |
| M15.8 | Other polyosteoarthritis | rtmccm | not risk adjusted |
| M15.9 | Polyosteoarthritis, unspecified | rtmccm | not risk adjusted |
| M16.0 | Bilateral primary osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.10 | Unilateral primary osteoarthritis, unspecified hip | rtmccm | not risk adjusted |
| M16.11 | Unilateral primary osteoarthritis, right hip | rtmccm | not risk adjusted |
| M16.12 | Unilateral primary osteoarthritis, left hip | rtmccm | not risk adjusted |
| M16.2 | Bilateral osteoarthritis resulting from hip dysplasia | rtmccm | not risk adjusted |
| M16.30 | Unilateral osteoarthritis resulting from hip dysplasia, unspecified hip | rtmccm | not risk adjusted |
| M16.31 | Unilateral osteoarthritis resulting from hip dysplasia, right hip | rtmccm | not risk adjusted |
| M16.32 | Unilateral osteoarthritis resulting from hip dysplasia, left hip | rtmccm | not risk adjusted |
| M16.4 | Bilateral post-traumatic osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.50 | Unilateral post-traumatic osteoarthritis, unspecified hip | rtmccm | not risk adjusted |
| M16.51 | Unilateral post-traumatic osteoarthritis, right hip | rtmccm | not risk adjusted |
| M16.52 | Unilateral post-traumatic osteoarthritis, left hip | rtmccm | not risk adjusted |
| M16.6 | Other bilateral secondary osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.7 | Other unilateral secondary osteoarthritis of hip | rtmccm | not risk adjusted |
| M16.9 | Osteoarthritis of hip, unspecified | rtmccm | not risk adjusted |
| M17.0 | Bilateral primary osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.10 | Unilateral primary osteoarthritis, unspecified knee | rtmccm | not risk adjusted |
| M17.11 | Unilateral primary osteoarthritis, right knee | rtmccm | not risk adjusted |
| M17.12 | Unilateral primary osteoarthritis, left knee | rtmccm | not risk adjusted |
| M17.2 | Bilateral post-traumatic osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.30 | Unilateral post-traumatic osteoarthritis, unspecified knee | rtmccm | not risk adjusted |
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | rtmccm | not risk adjusted |
| M17.32 | Unilateral post-traumatic osteoarthritis, left knee | rtmccm | not risk adjusted |
| M17.4 | Other bilateral secondary osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.5 | Other unilateral secondary osteoarthritis of knee | rtmccm | not risk adjusted |
| M17.9 | Osteoarthritis of knee, unspecified | rtmccm | not risk adjusted |
| M18.0 | Bilateral primary osteoarthritis of first carpometacarpal joints | rtmccm | not risk adjusted |
| M18.10 | Unilateral primary osteoarthritis of first carpometacarpal joint, unspecified hand | rtmccm | not risk adjusted |
| M18.11 | Unilateral primary osteoarthritis of first carpometacarpal joint, right hand | rtmccm | not risk adjusted |
| M18.12 | Unilateral primary osteoarthritis of first carpometacarpal joint, left hand | rtmccm | not risk adjusted |
| M18.2 | Bilateral post-traumatic osteoarthritis of first carpometacarpal joints | rtmccm | not risk adjusted |
| M18.30 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, unspecified hand | rtmccm | not risk adjusted |
| M18.31 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, right hand | rtmccm | not risk adjusted |
| M18.32 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, left hand | rtmccm | not risk adjusted |
| M18.4 | Other bilateral secondary osteoarthritis of first carpometacarpal joints | rtmccm | not risk adjusted |
| M18.50 | Other unilateral secondary osteoarthritis of first carpometacarpal joint, unspecified hand | rtmccm | not risk adjusted |
| M18.51 | Other unilateral secondary osteoarthritis of first carpometacarpal joint, right hand | rtmccm | not risk adjusted |
| M18.52 | Other unilateral secondary osteoarthritis of first carpometacarpal joint, left hand | rtmccm | not risk adjusted |
| M18.9 | Osteoarthritis of first carpometacarpal joint, unspecified | rtmccm | not risk adjusted |
| M19.011 | Primary osteoarthritis, right shoulder | rtmccm | not risk adjusted |
| M19.012 | Primary osteoarthritis, left shoulder | rtmccm | not risk adjusted |
| M19.019 | Primary osteoarthritis, unspecified shoulder | rtmccm | not risk adjusted |
| M19.021 | Primary osteoarthritis, right elbow | rtmccm | not risk adjusted |
| M19.022 | Primary osteoarthritis, left elbow | rtmccm | not risk adjusted |
| M19.029 | Primary osteoarthritis, unspecified elbow | rtmccm | not risk adjusted |
| M19.031 | Primary osteoarthritis, right wrist | rtmccm | not risk adjusted |
| M19.032 | Primary osteoarthritis, left wrist | rtmccm | not risk adjusted |
| M19.039 | Primary osteoarthritis, unspecified wrist | rtmccm | not risk adjusted |
| M19.041 | Primary osteoarthritis, right hand | rtmccm | not risk adjusted |
| M19.042 | Primary osteoarthritis, left hand | rtmccm | not risk adjusted |
| M19.049 | Primary osteoarthritis, unspecified hand | rtmccm | not risk adjusted |
| M19.071 | Primary osteoarthritis, right ankle and foot | rtmccm | not risk adjusted |
| M19.072 | Primary osteoarthritis, left ankle and foot | rtmccm | not risk adjusted |
| M19.079 | Primary osteoarthritis, unspecified ankle and foot | rtmccm | not risk adjusted |
| M19.09 | Primary osteoarthritis, other specified site | rtmccm | not risk adjusted |
| M19.111 | Post-traumatic osteoarthritis, right shoulder | rtmccm | not risk adjusted |
| M19.112 | Post-traumatic osteoarthritis, left shoulder | rtmccm | not risk adjusted |
| M19.119 | Post-traumatic osteoarthritis, unspecified shoulder | rtmccm | not risk adjusted |
| M19.121 | Post-traumatic osteoarthritis, right elbow | rtmccm | not risk adjusted |
| M19.122 | Post-traumatic osteoarthritis, left elbow | rtmccm | not risk adjusted |
| M19.129 | Post-traumatic osteoarthritis, unspecified elbow | rtmccm | not risk adjusted |
| M19.131 | Post-traumatic osteoarthritis, right wrist | rtmccm | not risk adjusted |
| M19.132 | Post-traumatic osteoarthritis, left wrist | rtmccm | not risk adjusted |
| M19.139 | Post-traumatic osteoarthritis, unspecified wrist | rtmccm | not risk adjusted |
| M19.141 | Post-traumatic osteoarthritis, right hand | rtmccm | not risk adjusted |
| M19.142 | Post-traumatic osteoarthritis, left hand | rtmccm | not risk adjusted |
| M19.149 | Post-traumatic osteoarthritis, unspecified hand | rtmccm | not risk adjusted |
| M19.171 | Post-traumatic osteoarthritis, right ankle and foot | rtmccm | not risk adjusted |
| M19.172 | Post-traumatic osteoarthritis, left ankle and foot | rtmccm | not risk adjusted |
| M19.179 | Post-traumatic osteoarthritis, unspecified ankle and foot | rtmccm | not risk adjusted |
| M19.19 | Post-traumatic osteoarthritis, other specified site | rtmccm | not risk adjusted |
| M19.211 | Secondary osteoarthritis, right shoulder | rtmccm | not risk adjusted |
| M19.212 | Secondary osteoarthritis, left shoulder | rtmccm | not risk adjusted |
| M19.219 | Secondary osteoarthritis, unspecified shoulder | rtmccm | not risk adjusted |
| M19.221 | Secondary osteoarthritis, right elbow | rtmccm | not risk adjusted |
| M19.222 | Secondary osteoarthritis, left elbow | rtmccm | not risk adjusted |
| M19.229 | Secondary osteoarthritis, unspecified elbow | rtmccm | not risk adjusted |
| M19.231 | Secondary osteoarthritis, right wrist | rtmccm | not risk adjusted |
| M19.232 | Secondary osteoarthritis, left wrist | rtmccm | not risk adjusted |
| M19.239 | Secondary osteoarthritis, unspecified wrist | rtmccm | not risk adjusted |
| M19.241 | Secondary osteoarthritis, right hand | rtmccm | not risk adjusted |
| M19.242 | Secondary osteoarthritis, left hand | rtmccm | not risk adjusted |
| M19.249 | Secondary osteoarthritis, unspecified hand | rtmccm | not risk adjusted |
| M19.271 | Secondary osteoarthritis, right ankle and foot | rtmccm | not risk adjusted |
| M19.272 | Secondary osteoarthritis, left ankle and foot | rtmccm | not risk adjusted |
| M19.279 | Secondary osteoarthritis, unspecified ankle and foot | rtmccm | not risk adjusted |
| M19.29 | Secondary osteoarthritis, other specified site | rtmccm | not risk adjusted |
| M19.90 | Unspecified osteoarthritis, unspecified site | rtmccm | not risk adjusted |
| M19.91 | Primary osteoarthritis, unspecified site | rtmccm | not risk adjusted |
| M19.92 | Post-traumatic osteoarthritis, unspecified site | rtmccm | not risk adjusted |
| M19.93 | Secondary osteoarthritis, unspecified site | rtmccm | not risk adjusted |
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmDisease-activity scores, function and therapy adherence.
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmCMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)
This family runs to 743 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M05, M06, M08, M12, M13, M45, M46.
Low back pain and dorsalgia
M54, M51.1, M51.3, M47.81, M43.166 codesrtmccmPain, function and home-exercise adherence, the standard RTM programme.
Low back pain and dorsalgia
M54, M51.1, M51.3, M47.81, M43.166 codesrtmccmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
M54.5 was deleted on 2021-10-01. Code to M54.50, M54.51 (vertebrogenic) or M54.59.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| M43.10 | Spondylolisthesis, site unspecified | rtmccm | not risk adjusted |
| M43.11 | Spondylolisthesis, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M43.12 | Spondylolisthesis, cervical region | rtmccm | not risk adjusted |
| M43.13 | Spondylolisthesis, cervicothoracic region | rtmccm | not risk adjusted |
| M43.14 | Spondylolisthesis, thoracic region | rtmccm | not risk adjusted |
| M43.15 | Spondylolisthesis, thoracolumbar region | rtmccm | not risk adjusted |
| M43.16 | Spondylolisthesis, lumbar region | rtmccm | not risk adjusted |
| M43.17 | Spondylolisthesis, lumbosacral region | rtmccm | not risk adjusted |
| M43.18 | Spondylolisthesis, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M43.19 | Spondylolisthesis, multiple sites in spine | rtmccm | not risk adjusted |
| M47.811 | Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region | rtmccm | not risk adjusted |
| M47.813 | Spondylosis without myelopathy or radiculopathy, cervicothoracic region | rtmccm | not risk adjusted |
| M47.814 | Spondylosis without myelopathy or radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M47.815 | Spondylosis without myelopathy or radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M47.816 | Spondylosis without myelopathy or radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M47.817 | Spondylosis without myelopathy or radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M47.818 | Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M47.819 | Spondylosis without myelopathy or radiculopathy, site unspecified | rtmccm | not risk adjusted |
| M51.14 | Intervertebral disc disorders with radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M51.15 | Intervertebral disc disorders with radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M51.16 | Intervertebral disc disorders with radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M51.17 | Intervertebral disc disorders with radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M51.34 | Other intervertebral disc degeneration, thoracic region | rtmccm | not risk adjusted |
| M51.35 | Other intervertebral disc degeneration, thoracolumbar region | rtmccm | not risk adjusted |
| M51.360 | Other intervertebral disc degeneration, lumbar region with discogenic back pain only | rtmccm | not risk adjusted |
| M51.361 | Other intervertebral disc degeneration, lumbar region with lower extremity pain only | rtmccm | not risk adjusted |
| M51.362 | Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain | rtmccm | not risk adjusted |
| M51.369 | Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain | rtmccm | not risk adjusted |
| M51.370 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only | rtmccm | not risk adjusted |
| M51.371 | Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only | rtmccm | not risk adjusted |
| M51.372 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain | rtmccm | not risk adjusted |
| M51.379 | Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain | rtmccm | not risk adjusted |
| M54.00 | Panniculitis affecting regions of neck and back, site unspecified | rtmccm | not risk adjusted |
| M54.01 | Panniculitis affecting regions of neck and back, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M54.02 | Panniculitis affecting regions of neck and back, cervical region | rtmccm | not risk adjusted |
| M54.03 | Panniculitis affecting regions of neck and back, cervicothoracic region | rtmccm | not risk adjusted |
| M54.04 | Panniculitis affecting regions of neck and back, thoracic region | rtmccm | not risk adjusted |
| M54.05 | Panniculitis affecting regions of neck and back, thoracolumbar region | rtmccm | not risk adjusted |
| M54.06 | Panniculitis affecting regions of neck and back, lumbar region | rtmccm | not risk adjusted |
| M54.07 | Panniculitis affecting regions of neck and back, lumbosacral region | rtmccm | not risk adjusted |
| M54.08 | Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M54.09 | Panniculitis affecting regions, neck and back, multiple sites in spine | rtmccm | not risk adjusted |
| M54.10 | Radiculopathy, site unspecified | rtmccm | not risk adjusted |
| M54.11 | Radiculopathy, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M54.12 | Radiculopathy, cervical region | rtmccm | not risk adjusted |
| M54.13 | Radiculopathy, cervicothoracic region | rtmccm | not risk adjusted |
| M54.14 | Radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M54.15 | Radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M54.16 | Radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M54.17 | Radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M54.18 | Radiculopathy, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M54.2 | Cervicalgia | rtmccm | not risk adjusted |
| M54.30 | Sciatica, unspecified side | rtmccm | not risk adjusted |
| M54.31 | Sciatica, right side | rtmccm | not risk adjusted |
| M54.32 | Sciatica, left side | rtmccm | not risk adjusted |
| M54.40 | Lumbago with sciatica, unspecified side | rtmccm | not risk adjusted |
| M54.41 | Lumbago with sciatica, right side | rtmccm | not risk adjusted |
| M54.42 | Lumbago with sciatica, left side | rtmccm | not risk adjusted |
| M54.50 | Low back pain, unspecified | rtmccm | not risk adjusted |
| M54.51 | Vertebrogenic low back pain | rtmccm | not risk adjusted |
| M54.59 | Other low back pain | rtmccm | not risk adjusted |
| M54.6 | Pain in thoracic spine | rtmccm | not risk adjusted |
| M54.81 | Occipital neuralgia | rtmccm | not risk adjusted |
| M54.89 | Other dorsalgia | rtmccm | not risk adjusted |
| M54.9 | Dorsalgia, unspecified | rtmccm | not risk adjusted |
Osteoporosis
M80, M81, M85496 codes in familyccmrtmFall risk and activity, with therapy adherence for balance and strength programmes.
Osteoporosis
M80, M81, M85496 codes in familyccmrtmCMS chronic condition · CCW category: Osteoporosis With or Without Pathological Fracture · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
This family runs to 496 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M80, M81, M85.
Gout and crystal arthropathies
M1A, M10, M11460 codes in familyccmrtmFlare frequency and urate-lowering therapy adherence.
Gout and crystal arthropathies
M1A, M10, M11460 codes in familyccmrtmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
This family runs to 460 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M1A, M10, M11.
Mobility impairment and acquired deformity
M20, M21, M24, M25, R26, Z74.0, Z99.3596 codes in familyrtmccmGait, activity level and fall events.
Mobility impairment and acquired deformity
M20, M21, M24, M25, R26, Z74.0, Z99.3596 codes in familyrtmccmCMS other chronic or potentially disabling condition · CCW category: Mobility Impairments · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
This family runs to 596 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M20, M21, M24, M25, R26, Z74.0, Z99.3.
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Clinical Context
Why orthopedics practices benefit from RTM.
Orthopedic patients recovering from joint replacement or managing chronic conditions like osteoarthritis benefit from RTM through pain level tracking, therapy adherence monitoring, and functional outcome measurement.
FAQ
Common questions.
What ICD-10 codes qualify orthopedics patients for RTM?
CMS publishes no list of codes that qualify a patient for RTM: eligibility turns on the condition and on documented medical necessity. For orthopedics, 164 billable ICD-10-CM codes cover the conditions RTM manages, spanning 6 conditions including osteoarthritis, rheumatoid and inflammatory arthritis, low back pain and dorsalgia, osteoporosis, gout and crystal arthropathies, mobility impairment and acquired deformity.
How does CCN Health support orthopedics practices with RTM?
CCN Health provides turnkey RTM services for orthopedics practices, including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support.
What is the revenue potential for RTM in orthopedics?
Reimbursement varies by locality and payer contract, so see the RTM billing guide for current figures. Orthopedics practices with a high prevalence of these conditions generally see the most benefit, particularly when RTM is combined with RPM and CCM for patients whose needs are distinct enough to document separately.
Sources & Compliance
Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.
Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.
Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.
Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.