ICD-10-CM · Hip

M95.5

M95.5 identifies a structural deformity of the pelvis that developed after birth — not a congenital anomaly — including changes to the ilium, ischium, or overall pelvic architecture resulting from disease, injury, or mechanical stress.

Verified May 8, 2026 · 6 sources ↓

Status: Billable
Chapter: 13
Related CPT: 16
Region: Hip

Drawn from CDCICD10DataIcdlistAAPCGenhealth

Documentation tips

What should appear in the chart to support M95.5.

Source · Editorial brief grounded in 6 cited references ↓

Explicitly state that the deformity is acquired (not congenital) — a single word like 'post-traumatic,' 'secondary to,' or 'developed following' satisfies this requirement and distinguishes M95.5 from Q74.2.
Name the specific deformity type when known (e.g., pelvic obliquity, platypelloid pelvis, scoliotic pelvis, funnel pelvis) — the ICD-10-CM index maps all of these to M95.5, and specific terminology supports medical necessity.
Document the underlying etiology driving the pelvic deformity (prior fracture, metabolic bone disease, chronic hip OA, spinal deformity) — this supports additional diagnosis codes and justifies associated procedures.
Include imaging findings that confirm deformity: AP pelvis X-ray measurements, pelvic obliquity angle, acetabular version changes, or leg-length discrepancy noted on full-length standing films.
If pelvic deformity is documented as a complicating factor in surgical planning (e.g., affecting acetabular cup placement in THA), note this explicitly in the operative or pre-op documentation to support medical necessity of any modified approach.

Related CPT procedures

Procedure codes commonly billed with M95.5. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

27130 $1,162.02

Primary total hip arthroplasty replacing both the acetabular socket and proximal femoral components with prosthetic implants, with or without bone graft.

27132 $1,504.04

Conversion of a previously operated hip — any prior surgery except total hip arthroplasty — to a complete total hip arthroplasty, replacing both femoral and acetabular components, with or without bone graft.

27137 $1,317.67

Revision of a total hip arthroplasty involving the acetabular component only, with or without autograft or allograft

27138 $1,367.10

Revision of total hip arthroplasty involving removal and replacement of the femoral component only, with or without bone graft.

27158 $1,267.56

Bilateral pelvic osteotomy performed to correct congenital or developmental pelvic malalignment, typically in pediatric patients

27161 $1,115.59

Femoral neck osteotomy in which a wedge of bone is resected from the femoral neck to correct alignment between the femoral head and shaft.

27165 $1,259.55

Intertrochanteric or subtrochanteric femoral osteotomy with internal or external fixation and/or cast application to correct deformity or malalignment in the proximal femur.

27170 $1,065.15

Bone grafting of the femoral head, neck, intertrochanteric, or subtrochanteric area, including harvest of the autograft from the patient's own body.

27175 $620.92

Treatment of slipped femoral capital epiphysis using skeletal traction alone, without any reduction maneuver to realign the displaced growth plate.

27176 $856.73

Surgical stabilization of a slipped capital femoral epiphysis (SCFE) using single or multiple pins inserted in situ through percutaneous stab incisions.

73502 $48.77

Radiologic exam of a single hip, capturing two or three views, including the pelvis when performed.

73503 $62.79

Radiologic examination of a single hip, including the pelvis when performed, capturing a minimum of four views from different angles.

73521 $41.75

Bilateral hip X-ray examination capturing two radiographic views of both hips, including the pelvis when performed.

73522 $54.44

Bilateral hip X-ray examination capturing 3 to 4 views, including the pelvis when clinically indicated.

72170 $28.06

Radiologic examination of the pelvis capturing one or two views, used to evaluate pelvic bones, sacrum, and coccyx for fractures, arthritis, or other structural abnormalities.

72190 $43.42

Radiologic examination of the pelvis requiring a minimum of three separate views, capturing the pelvic bones, hip joints, and surrounding structures.

Common coding pitfalls

The recurring mistakes coders make with M95.5 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Coding M95.5 for a congenital pelvic malformation — if the medical record indicates the deformity was present at birth or is part of a congenital syndrome, Q74.2 is the correct code, not M95.5.
Using M95.5 as a primary diagnosis when the deformity is purely incidental and the visit is driven by a separate condition (e.g., hip OA) — sequence M95.5 as a secondary code behind the condition that prompted the encounter.
Defaulting to M95.9 (acquired deformity of musculoskeletal system, unspecified) when documentation clearly specifies the pelvis — M95.5 is the billable specific code and should be used whenever pelvic involvement is documented.
Omitting the etiology code — pelvic deformity is rarely the root diagnosis; failure to code the underlying cause (e.g., malunited pelvic fracture, rickets sequela, lumbar scoliosis) leaves the clinical picture incomplete and can trigger medical necessity questions.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

M95.5 captures a broad range of non-congenital pelvic shape abnormalities. Covered presentations include pelvic obliquity, scoliotic or kyphotic pelvis, platypelloid pelvis, Nägele's pelvis, funnel pelvis, spondylolisthetic pelvis, coxalgic pelvis, and tipping or tilting of the pelvis acquired after birth. These deformities typically arise as sequelae of prior fracture malunion, metabolic bone disease (e.g., rickets-related kyphorachitic pelvis), chronic hip pathology, or progressive spinal deformity that loads the pelvis asymmetrically.

In an orthopedic practice, M95.5 most often surfaces when a patient presents with secondary complaints — hip impingement, leg-length discrepancy, gait abnormality, or low back pain — where imaging reveals underlying pelvic asymmetry or structural distortion that is not attributable to a congenital condition. It is also used to document pelvic deformity as a comorbidity that affects surgical planning or outcomes (e.g., THA approach, acetabular cup positioning).

Critical distinction: if the deformity is congenital, code Q74.2 (Other congenital malformations of lower limb(s), including pelvic girdle) instead. Documentation must support that the deformity is acquired — meaning it developed or progressed after birth. M95.5 has no laterality subcode; the index acknowledges right, left, and bilateral presentations as approximate synonyms under the same code.

Inclusion & exclusion notes

Per the official ICD-10-CM Tabular List.

Source · CDC ICD-10-CM Official Tabular List · 2026

Excludes 1 — never code together

maternal care for known or suspected disproportion (O33.-)

Sibling codes

Other billable codes under M95 (laterality / anatomic variants).

M95.8

Oth acquired deformities of musculoskeletal system

M95.0

Acquired deformity of nose

M95.2

Other acquired deformity of head

M95.3

Acquired deformity of neck

M95.9

Acquired deformity of musculoskeletal system, unspecified

M95.4

Acquired deformity of chest and rib

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between M95.5 and Q74.2?

M95.5 is for pelvic deformity that developed after birth — acquired. Q74.2 covers congenital malformations of the lower limb and pelvic girdle present at or before birth. If the medical record doesn't specify, document whether the deformity is congenital or acquired before assigning either code.

02Does M95.5 have laterality subcodes?

No. M95.5 is a single billable code with no 6th-character laterality extension. Right, left, and bilateral pelvic deformity all map to M95.5. If laterality is clinically relevant, capture it in the note but the code remains the same.

03Can M95.5 be used as a primary diagnosis?

Yes, it is billable as a primary diagnosis when the acquired pelvic deformity is the condition being evaluated or managed. In most orthopedic encounters, however, it sequences as a secondary code behind the presenting complaint (e.g., hip OA, leg-length discrepancy, gait disturbance).

04What pelvic deformity types map to M95.5?

The ICD-10-CM index maps all of the following to M95.5: pelvic obliquity, platypelloid pelvis, funnel pelvis, Nägele's pelvis, kyphorachitic pelvis, kyphoscoliorachitic pelvis, kyphoscoliotic pelvis, scoliotic pelvis, lordotic pelvis, spondylolisthetic pelvis, coxalgic pelvis, infantile pelvis, and pelvic tipping or tilting — as long as all are acquired, not congenital.

05Should M95.5 be coded when pelvic obliquity is caused by leg-length discrepancy?

Yes, if the documentation confirms structural pelvic deformity. Code the leg-length discrepancy (M21.7x) as well. Sequence based on which condition is the primary reason for the encounter.

06What MS-DRGs does M95.5 group into?

M95.5 groups into MS-DRG v43.0: 564 (Other musculoskeletal system and connective tissue diagnoses with MCC), 565 (with CC), or 566 (without CC/MCC), depending on comorbidities documented in the encounter.

07Is imaging required to support M95.5?

No specific imaging requirement exists in ICD-10-CM guidelines, but AP pelvis radiographs or CT confirming pelvic asymmetry, obliquity angle, or structural distortion significantly strengthen medical necessity documentation and reduce audit risk.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira captures documentation elements that lock in M95.5: explicit 'acquired' qualifier, deformity type (obliquity, tipping, funnel, platypelloid, etc.), underlying etiology, and imaging measurements confirming structural change. This prevents downcoding to M95.9 (unspecified) and flags missing congenital-vs-acquired distinction that auditors use to challenge Q74.2 vs. M95.5 assignments.

See how Mira captures M95.5 documentation