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M19.012
ICD-10-CM
Left Shoulder Osteoarthritis

Find information on Left Shoulder Osteoarthritis diagnosis, including clinical documentation, medical coding, ICD-10 codes (M19.02), and treatment options. Learn about symptoms, diagnosis criteria, and healthcare management of left shoulder osteoarthritis. This resource provides guidance for accurate medical coding and documentation for healthcare professionals. Explore resources for managing and treating left shoulder osteoarthritis pain and improving patient outcomes.

Also known as

Left Shoulder OA
Degenerative Joint Disease of Left Shoulder

Diagnosis Snapshot

Key Facts
  • Definition : Degenerative joint disease causing cartilage breakdown in the left shoulder.
  • Clinical Signs : Left shoulder pain, stiffness, limited range of motion, creaking, and swelling.
  • Common Settings : Primary care, orthopedics, physical therapy, and pain management clinics.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M19.012 Coding
M15-M19

Osteoarthritis

Covers various forms of osteoarthritis, including shoulder.

M19.0

Primary osteoarthritis

Includes primary osteoarthritis of specific sites like the shoulder.

M19.01

Primary osteoarthritis, shoulder

Specifies primary osteoarthritis localized to the shoulder joint.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is it primary (idiopathic) OA?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Left Shoulder Osteoarthritis
Right Shoulder Osteoarthritis
Glenohumeral Osteoarthritis

Documentation Best Practices

Documentation Checklist
  • Left shoulder pain, stiffness, limited ROM documentation
  • Osteoarthritis diagnosis confirmed via imaging (X-ray, MRI)
  • Symptom duration and severity: acute, chronic, impact on ADLs
  • Medical coding: ICD-10 M19.012 Left glenohumeral osteoarthritis
  • Treatment plan: conservative, surgical, pain management documented

Coding and Audit Risks

Common Risks
  • Laterality Miscoding

    Incorrectly coding the right shoulder or unspecified shoulder instead of the left, leading to inaccurate data and claims.

  • Specificity Undercoding

    Using a generic osteoarthritis code without specifying the affected joint (shoulder) causing loss of clinical detail and revenue.

  • Post-traumatic OA Miss

    Failing to document and code any history of trauma contributing to the osteoarthritis, impacting severity and treatment.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding (M19.01) for Left Shoulder OA improves reimbursement.
  • Specific documentation of pain, stiffness, ROM limitations supports M19.01 diagnosis.
  • Regular CDI reviews ensure complete documentation for Left Shoulder Osteoarthritis.
  • Timely follow-up care coded with Z09 or Z87.325 enhances healthcare compliance.
  • Use SNOMED CT (192818002) for interoperability and consistent Left Shoulder OA data.

Clinical Decision Support

Checklist
  • 1. Verify left shoulder pain duration > 4 weeks: ICD-10 M19.01
  • 2. Confirm limited ROM left shoulder: CPT 99202-99205
  • 3. Check left shoulder imaging for osteophytes: SNOMED CT 234108001
  • 4. Exclude other left shoulder diagnoses: rotator cuff tear, adhesive capsulitis

Reimbursement and Quality Metrics

Impact Summary
  • Left Shoulder Osteoarthritis: ICD-10 M19.0, CPT 20610 (injection), 97140 (PT). Accurate coding maximizes reimbursement.
  • Coding errors for M19.0 impact hospital revenue cycle, denials increase costs.
  • Osteoarthritis quality metrics: Pain management, functional improvement. Accurate codes reflect care quality.
  • Shoulder osteoarthritis reporting: Data validity crucial for resource allocation, quality improvement programs.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code M19.01 for primary osteoarthritis left shoulder
  • Document symptom laterality (left)
  • Specify osteophyte, joint space narrowing if present
  • Consider 718.31 for adhesive capsulitis if applicable
  • Exclude other shoulder diagnoses in documentation

Documentation Templates

Patient presents with complaints of left shoulder pain consistent with osteoarthritis.  Symptoms include chronic aching, stiffness, and limited range of motion in the left shoulder joint.  Onset of symptoms is gradual and reported as worsening over the past six months.  Pain is exacerbated by activity and relieved by rest.  Patient denies any history of acute trauma to the left shoulder.  Physical examination reveals tenderness to palpation of the left glenohumeral joint, crepitus upon passive range of motion, and reduced abduction and external rotation compared to the right shoulder.  Radiographic imaging of the left shoulder demonstrates joint space narrowing, osteophyte formation, and subchondral sclerosis, consistent with the diagnosis of left shoulder osteoarthritis.  Differential diagnoses considered included rotator cuff tear, adhesive capsulitis, and cervical radiculopathy.  Assessment: Primary diagnosis of left shoulder osteoarthritis ICD-10 code M19.01.  Treatment plan includes conservative management with nonsteroidal anti-inflammatory drugs NSAIDs for pain management, physical therapy for range of motion and strengthening exercises, and patient education on activity modification.  Follow-up scheduled in four weeks to assess response to treatment.  Referral to orthopedics will be considered if symptoms do not improve with conservative measures.