ICD-10 Coding for Osteoarthritis of the Left Shoulder(M19.012)
Complete ICD-10-CM coding and documentation guide for Osteoarthritis of the Left Shoulder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Osteoarthritis of the Left Shoulder
M15-M19Primary Range
Osteoarthritis
This range includes all osteoarthritis codes, with M19.012 specifically for primary OA of the left shoulder.
Key Information: ICD-10 code for osteoarthritis left shoulder
Essential facts and insights about Osteoarthritis of the Left Shoulder
Primary ICD-10-CM Code for osteoarthritis left shoulder
Decision Criteria
clinical Criteria
- Confirmed OA via imaging without prior trauma
Applicable To
- Degenerative joint disease of the left shoulder
Clinical Validation Requirements
- X-ray showing joint space narrowing and osteophytes
- No history of trauma or inflammatory arthritis
Code-Specific Risks
- Risk of using unspecified codes when laterality is documented
Coding Notes
- Ensure imaging confirms OA diagnosis before coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pain in left shoulder
M25.512Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Post-traumatic osteoarthritis, left shoulder
M19.112Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Osteoarthritis of the Left Shoulder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M19.012.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always include imaging results in the patient's record., Train staff on documentation standards.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify laterality if documented, using M19.012 for left shoulder.
Impact
Failure to document laterality can lead to audit flags.
Mitigation Strategy
Implement checklist for documentation completeness.
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 Osteoarthritis of the Left Shoulder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Osteoarthritis of the Left Shoulder
Use these documentation templates to ensure complete and accurate documentation for Osteoarthritis of the Left Shoulder. These templates include all required elements for proper coding and billing.
Initial diagnosis of primary OA
Specialty: OrthopedicsRequired Elements
- Patient history
- Imaging results
- Physical examination findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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