ICD-10 Coding for Osteoarthritis of the Shoulder(M19.01, M19.011, M19.011B)

Learn about ICD-10 coding for osteoarthritis of the shoulder, including primary and secondary codes, documentation requirements, and common pitfalls.

Also known as:
Degenerative Joint Disease of the ShoulderShoulder OA
Related ICD-10 Code Ranges

Complete code families applicable to Osteoarthritis of the Shoulder

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescription
M19.011Primary osteoarthritis, right shoulder
M19.012Primary osteoarthritis, left shoulder

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information

Essential facts and insights aboutOsteoarthritis of the Shoulder

Differential Codes

Alternative codes to consider when ruling out similar conditions

Post-traumatic osteoarthritis, right shoulderM19.111

Use when OA is due to previous trauma.

Post-traumatic osteoarthritis, left shoulderM19.112

Use when OA is due to previous trauma.

Documentation & Coding Risks

Avoid these common issues when documenting Osteoarthritis of the Shoulder.

Failing to document laterality

Impact

Clinical: Ambiguity in treatment planning., Regulatory: Non-compliance with ICD-10 coding rules., Financial: Potential claim denials.

Mitigation

Train staff on the importance of documenting laterality., Use templates that prompt for laterality.

Using a single code for bilateral shoulder osteoarthritis

Impact

Reimbursement: Incorrect coding can lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records and data reporting.

Mitigation

Use two separate codes for each shoulder: M19.011 and M19.012.

Laterality Documentation

Impact

Failure to document laterality can lead to audit findings.

Mitigation

Ensure all clinical documentation includes laterality.

Frequently Asked Questions