ICD-10 Coding for Arthritis of the Right Clavicle(M19.011, M19.211)
Complete ICD-10-CM coding and documentation guide for Arthritis of the Right Clavicle. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Arthritis of the Right Clavicle
M19.01-M19.03Primary Range
Primary osteoarthritis of the shoulder region
This range includes codes for primary osteoarthritis affecting the shoulder region, including the acromioclavicular joint.
Secondary osteoarthritis of the shoulder region
This range includes codes for secondary osteoarthritis due to trauma or other causes affecting the shoulder region.
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 degenerative changes are isolated to the right AC joint without prior trauma. |
|
| M19.211 | Secondary osteoarthritis, right shoulder | Use when arthritis is linked to prior injury or surgery. |
|
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 arthritis right clavicle
Essential facts and insights about Arthritis of the Right Clavicle
Primary ICD-10-CM Codes for arthritis right clavicle
Decision Criteria
clinical Criteria
- Presence of degenerative changes without trauma history
documentation Criteria
- X-ray evidence of osteophytes and joint space narrowing
Applicable To
- Degenerative changes in the right acromioclavicular joint
Excludes
- Secondary osteoarthritis due to trauma (M19.211)
Clinical Validation Requirements
- X-ray showing joint space narrowing, osteophytes
- Clinical exam confirming pain localized to AC joint
Code-Specific Risks
- Misclassification as secondary osteoarthritis if trauma history is present
Coding Notes
- Ensure documentation specifies primary vs. secondary osteoarthritis.
M19.211 - Secondary osteoarthritis, right shoulder
Use when arthritis is linked to prior injury or surgery.
Applicable To
- Post-traumatic arthritis of the right shoulder
Excludes
- Primary osteoarthritis (M19.011)
Clinical Validation Requirements
- History of trauma or surgery
- Imaging showing joint incongruity
Coding Notes
Document the underlying cause of the secondary osteoarthritis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acquired absence of right upper limb below shoulder
Z89.111Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Arthritis of the Right Clavicle to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M19.011.
Impact
Clinical: Leads to incomplete diagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always include imaging results in documentation.
Impact
Reimbursement: May lead to claim denials due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of health records.
Mitigation Strategy
Always specify laterality and use M19.011 for right shoulder.
Impact
Failure to specify laterality can lead to audit issues.
Mitigation Strategy
Ensure all documentation includes laterality.
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 Arthritis of the Right Clavicle, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Arthritis of the Right Clavicle
Use these documentation templates to ensure complete and accurate documentation for Arthritis of the Right Clavicle. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for shoulder pain
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Diagnosis and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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