M02.112
BillablePostdysenteric arthropathy, left shoulder
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is M02.112 an HCC code?
Yes. M02.112 maps to Bone/Joint/Muscle Infections/Necrosis under the CMS-HCC V28 risk adjustment model (and Bone/Joint/Muscle Infections/Necrosis under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for M02.112
For M02.112to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed M02.112 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
M02.112 is the ICD-10-CM diagnosis code for postdysenteric arthropathy, left shoulder. Joint inflammation and pain in the left shoulder that develops as a complication following a dysentery infection. M02.112 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering infectious arthropathies (m00-m02).
Under the CMS-HCC V28 risk adjustment model, M02.112 maps to Bone/Joint/Muscle Infections/Necrosis (HCC 92) with a community, non-dual, aged base RAF weight of 0.209. Under the older V24 model, M02.112 mapped to the same category but with a base RAF weight of 0.482 — V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Confirm laterality is documented as left; right shoulder requires code M02.111. Because M02.112 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M02.112 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm laterality is documented as left; right shoulder requires code M02.111
- •Document the timeframe between dysentery onset and arthropathy development when available
Clinical Significance
Postdysenteric arthropathy of the left shoulder represents a specific reactive joint condition following dysentery infection, causing inflammatory changes in the left shoulder joint. This condition demonstrates how gastrointestinal infections can trigger persistent joint symptoms that significantly impact upper extremity function and quality of life.
Documentation Requirements
- ✓Specific documentation of left shoulder joint involvement
- ✓Clear history of antecedent dysentery infection
- ✓Temporal relationship between dysenteric illness and shoulder symptom onset
- ✓Physical examination documenting left shoulder inflammation and functional limitation
- ✓Laboratory evidence excluding active joint infection or other causes
- ✓Confirmation of reactive rather than direct infectious etiology
- ✓Treatment approach focused on anti-inflammatory therapy
- ✓Assessment of functional impact on left shoulder mobility and strength
Commonly Confused Codes
- •M02.111 — Postdysenteric arthropathy, right shoulder (wrong laterality)
- •M00.912 — Pyogenic arthritis, left shoulder (direct bacterial joint infection)
- •M25.512 — Pain in left shoulder (joint symptoms without reactive component)
- •M75.32 — Calcific tendinitis of left shoulder (calcium deposit rather than reactive condition)