A 2026 ICD-10 Coding Guide for Acute Hip Pain

Acute hip pain is sudden, intense discomfort in the hip joint that disrupts movement and daily function. Accurate ICD-10 coding for acute hip pain is essential for proper diagnosis documentation, insurance reimbursement, and care coordination. The 2026 ICD-10-CM code set, effective October 1, 2025, includes specific codes for 7 major hip conditions. Each condition requires precise laterality and clinical context to ensure compliant billing.

This guide covers the most common causes of acute hip pain and the correct 2026 ICD-10-CM codes for each condition, sourced directly from the official CMS ICD-10-CM code set.

What Are the Common Causes of Acute Hip Pain?

Acute hip pain results from 7 primary musculoskeletal conditions: osteoarthritis, sacroiliac joint dysfunction, bursitis, labral tears, hip impingement, hip flexor strain, and iliotibial band syndrome. Each condition affects a different structure within or around the hip joint and requires its own ICD-10 code for accurate documentation.

• Osteoarthritis: degenerative joint disease causing progressive cartilage breakdown
• Sacroiliac Joint Dysfunction: disruption in the joint connecting the sacrum to the pelvis
• Bursitis: inflammation of the fluid-filled sacs (bursae) that cushion the hip
• Labral Tear: damage to the cartilage ring that stabilizes the hip socket
• Hip Impingement (FAI): abnormal bone contact between the femoral head and acetabulum
• Hip Flexor Strain: overstretching of the muscles connecting the femur to the lower back
• Iliotibial Band Syndrome: overuse injury causing friction along the iliotibial band

What Is Osteoarthritis of the Hip?

Osteoarthritis of the hip is a noninflammatory degenerative joint disease in which articular cartilage progressively breaks down, causing pain, stiffness, and reduced range of motion. Osteoarthritis is the most common form of arthritis in the United States, affecting over 32.5 million adults.

Pain typically worsens with weight-bearing and motion. Coding specificity requires identifying whether the condition is primary or secondary, unilateral or bilateral, and which hip is affected for unilateral cases.

ICD-10 Codes for Osteoarthritis of the Hip

What Is Sacroiliac Joint Dysfunction?

Sacroiliac (SI) joint dysfunction is a condition in which abnormal movement in the joint connecting the sacrum to the iliac bones of the pelvis produces localized low back and hip pain. The abnormal movement can involve too much motion (hypermobility) or too little motion (hypomobility). The pain often radiates into the buttocks, groin, or thigh, mimicking sciatica.

Code selection depends on whether the presentation reflects somatic dysfunction, joint sprain, or sacroiliitis with inflammatory involvement.

ICD-10 Codes for Sacroiliac Joint Dysfunction (2026)

What Is Hip Bursitis?

Hip bursitis is inflammation of the bursae, which are small fluid-filled sacs that reduce friction between tissues in the hip joint. The 2 most commonly affected bursae are the trochanteric bursa on the outer hip and the iliopsoas bursa on the inner hip and groin. Bursitis produces localized tenderness, swelling, and a dull aching pain that worsens with activity or direct pressure.

Trochanteric bursitis is coded under M70.6x, while other hip bursitis falls under M70.7x. Both series require laterality specification.

ICD-10 Codes for Hip Bursitis (2026)

What Is a Hip Labral Tear?

A hip labral tear is a rip in the labrum, which is the ring of cartilage lining the acetabulum (hip socket) that stabilizes the femoral head and seals the joint. Labral tears cause groin pain, a clicking or catching sensation, hip stiffness, and reduced range of motion. They result from trauma, repetitive motion, structural abnormalities such as femoroacetabular impingement, or degeneration.

ICD-10-CM classifies labral tears under the S73 sprain category. Laterality, either right or left, is required for billable code selection.

ICD-10 Codes for Hip Labral Tear

What Is Hip Impingement (FAI)?

Hip impingement, or femoroacetabular impingement (FAI), occurs when abnormal bone contact develops between the femoral head and the acetabulum during hip movement. FAI presents in 2 forms: cam impingement, which involves a deformity on the femoral head, and pincer impingement, which involves overcoverage of the acetabulum. Both types restrict range of motion and produce groin pain, particularly during hip flexion.

ICD-10-CM codes FAI under the M24.85x joint derangement series. M76.21 and M76.22 (iliac crest spur) also list femoroacetabular impingement as an approximate synonym where structural deformity is the primary driver.

ICD-10 Codes for Hip Impingement

What Is a Hip Flexor Strain?

A hip flexor strain is an overstretching or tearing of the muscles and tendons that connect the femur to the lower back and pelvis. The primary muscles involved are the iliopsoas, rectus femoris, and sartorius. Hip flexor strains produce acute anterior hip or groin pain, weakness during leg elevation, and pain with resisted hip flexion. They are common in athletes and occur through overuse or sudden deceleration.

The S76 series covers strains of muscles, fascia, and tendons at the hip and thigh level. Laterality and encounter type, such as initial, subsequent, or sequela, must be specified.

ICD-10 Codes for Hip Flexor Strain

What Is Iliotibial Band Syndrome?

Iliotibial (IT) band syndrome is an overuse injury in which repetitive friction of the iliotibial band causes lateral hip and knee pain. The iliotibial band is the connective tissue that runs from the iliac crest along the outer thigh to the knee. According to the National Library of Medicine (NLM), ITBS is one of the most common overuse injuries in runners, with an incidence rate of 1.6% to 12% among running athletes.

ICD-10-CM M76.3x specifically classifies iliotibial band syndrome, with laterality codes for right, left, and unspecified leg.

ICD-10 Codes for Iliotibial Band Syndrome

Conclusion

Accurate ICD-10-CM coding for acute hip pain requires 3 key elements: the correct condition-specific code family, proper laterality (right, left, or unspecified), and the appropriate encounter type (initial, subsequent, or sequela) where applicable. Using unspecified codes when laterality is documented is one of the most common billing errors and increases claim denial risk.

All 2026 ICD-10-CM codes referenced in this guide are drawn from the official CMS code set, effective October 1, 2025. For the full 2026 ICD-10-CM tabular list and updates, refer directly to the CMS ICD-10-CM resources page.

It is crucial to understand that this guide or any other is intended for informational and educational purposes. Always verify codes against the current CMS ICD-10-CM tabular list and consult a certified medical coder (CPC or CCS) for clinical billing decisions.

FAQs

What Is the ICD-10 Code for Hip Pain When No Specific Diagnosis Is Confirmed? 

M25.559 is the ICD-10 code for unspecified hip pain, with M25.551 for the right hip and M25.552 for the left hip, used until a confirmed diagnosis is documented.

Is There a Separate ICD-10 Code for Acute Hip Pain vs. Chronic Hip Pain? 

ICD-10-CM does not separate acute from chronic hip pain by duration; acuity is captured through the encounter type qualifier and the underlying confirmed diagnosis code.

Why Does Laterality Matter for Hip Pain ICD-10 Codes? 

Most hip codes require laterality (right, left, or unspecified), and using an unspecified code when the clinical record documents a specific side is a leading cause of claim denials.

What Are the Most Common ICD-10 Coding Errors in Hip Pain Medical Billing? 

The 4 most common errors are: using unspecified laterality codes, coding M25.55x instead of the confirmed diagnosis, applying M-codes to traumatic injuries requiring S-codes, and omitting the encounter type qualifier on S-series codes.