ICD-10 Coding for Degenerative Arthritis of the Right Clavicle(M19.011, M19.031)
Complete ICD-10-CM coding and documentation guide for Degenerative 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 Degenerative Arthritis of the Right Clavicle
M19.0-M19.9Primary Range
Osteoarthritis
This range includes codes for primary and secondary osteoarthritis, applicable to joints such as the acromioclavicular and sternoclavicular joints.
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 imaging confirms primary OA of the right AC joint without trauma history. |
|
| M19.031 | Primary osteoarthritis, right sternoclavicular joint | Use when imaging confirms primary OA of the right SC 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 degenerative arthritis right clavicle
Essential facts and insights about Degenerative Arthritis of the Right Clavicle
Primary ICD-10-CM Codes for degenrative arthritis right clavicle
Decision Criteria
clinical Criteria
- Imaging confirms AC joint OA without trauma.
documentation Criteria
- Documentation specifies 'primary osteoarthritis of right AC joint'.
Applicable To
- Primary osteoarthritis of the right acromioclavicular joint
Clinical Validation Requirements
- Imaging showing joint space narrowing
- Presence of osteophytes
Code-Specific Risks
- Confusing AC joint with glenohumeral joint
- Not specifying laterality
Coding Notes
- Ensure documentation specifies the exact joint and laterality.
M19.031 - Primary osteoarthritis, right sternoclavicular joint
Use when imaging confirms primary OA of the right SC joint.
Applicable To
- Primary osteoarthritis of the right sternoclavicular joint
Excludes
- Traumatic arthritis (M12.5-)
- Rheumatoid arthritis (M05.4-)
Clinical Validation Requirements
- Medial clavicle irregularity
- Joint space reduction
Coding Notes
Ensure documentation specifies the exact joint 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 Degenerative 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: May lead to incorrect treatment plans., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Always document the specific joint., Use imaging to confirm diagnosis.
Impact
Reimbursement: May lead to denials due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of health data.
Mitigation Strategy
Specify AC or SC joint with M19.011 or M19.031.
Impact
High risk of audit if unspecified codes are used for shoulder OA.
Mitigation Strategy
Use specific codes for AC or SC joint involvement.
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 Degenerative Arthritis of the Right Clavicle, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Degenerative Arthritis of the Right Clavicle
Use these documentation templates to ensure complete and accurate documentation for Degenerative Arthritis of the Right Clavicle. These templates include all required elements for proper coding and billing.
Documenting primary OA of the right AC joint
Specialty: OrthopedicsRequired Elements
- Joint involved
- Laterality
- Imaging findings
- Clinical symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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