ICD-10 Coding for Acromioclavicular Joint Osteoarthritis(M19.011, M19.012, M19.111)
Complete ICD-10-CM coding and documentation guide for Acromioclavicular Joint Osteoarthritis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acromioclavicular Joint Osteoarthritis
M19.01-M19.12Primary Range
Primary osteoarthritis of shoulder region
This range includes codes for primary osteoarthritis affecting the shoulder region, which encompasses the acromioclavicular joint.
Post-traumatic osteoarthritis of shoulder region
This range is used when osteoarthritis is secondary to trauma, such as a previous injury to the acromioclavicular joint.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M19.011 | Primary osteoarthritis, right shoulder | Use when primary osteoarthritis is diagnosed in the right acromioclavicular joint. |
|
| M19.012 | Primary osteoarthritis, left shoulder | Use when primary osteoarthritis is diagnosed in the left acromioclavicular joint. |
|
| M19.111 | Post-traumatic osteoarthritis, right shoulder | Use when osteoarthritis is secondary to trauma in the right acromioclavicular joint. |
|
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: ICD-10 code for acromioclavicular joint osteoarthritis
Essential facts and insights about Acromioclavicular Joint Osteoarthritis
Primary ICD-10-CM Codes for acromioclavicular joint osteoarthritis
Decision Criteria
clinical Criteria
- Presence of joint space narrowing and osteophytes on imaging
Applicable To
- Primary osteoarthritis of right acromioclavicular joint
Excludes
- Post-traumatic osteoarthritis (M19.111)
Clinical Validation Requirements
- Tenderness over right AC joint
- Radiographic evidence of joint space narrowing and osteophytes
Code-Specific Risks
- Ensure laterality is documented to avoid unspecified coding.
Coding Notes
- Ensure documentation specifies 'primary' osteoarthritis and laterality.
M19.012 - Primary osteoarthritis, left shoulder
Use when primary osteoarthritis is diagnosed in the left acromioclavicular joint.
Applicable To
- Primary osteoarthritis of left acromioclavicular joint
Excludes
- Post-traumatic osteoarthritis (M19.112)
Clinical Validation Requirements
- Tenderness over left AC joint
- Radiographic evidence of joint space narrowing and osteophytes
Coding Notes
Ensure documentation specifies 'primary' osteoarthritis and laterality.
M19.111 - Post-traumatic osteoarthritis, right shoulder
Use when osteoarthritis is secondary to trauma in the right acromioclavicular joint.
Applicable To
- Post-traumatic osteoarthritis of right acromioclavicular joint
Excludes
- Primary osteoarthritis (M19.011)
Clinical Validation Requirements
- History of trauma to right AC joint
- Radiographic evidence of post-traumatic changes
Coding Notes
Ensure documentation includes trauma history and laterality.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acromioclavicular Joint Osteoarthritis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M19.011.
Impact
Clinical: May lead to incorrect treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or audits.
Mitigation Strategy
Review patient history for prior injuries., Document any relevant trauma events.
Impact
Reimbursement: May result in denied claims or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify laterality (right or left) in documentation to use the correct code.
Impact
Missing laterality can lead to coding errors.
Mitigation Strategy
Implement checklist for documentation review.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acromioclavicular Joint Osteoarthritis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acromioclavicular Joint Osteoarthritis
Use these documentation templates to ensure complete and accurate documentation for Acromioclavicular Joint Osteoarthritis. These templates include all required elements for proper coding and billing.
Orthopedic evaluation of ACJ osteoarthritis
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Diagnosis
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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