FY2027 ICD-10-CM reference
M02.219: Postimmunization arthropathy, unspecified shoulder
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Postimmunization arthropathy, unspecified shoulder. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
CMS-HCC V28
No V28 HCC for 2026 dates of service (CMS 2027 Initial ICD-10-CM Mappings)
CMS-HCC V24
Not used for payment year 2027 Medicare Advantage payment
ESRD
No category in the PY2026 CMS mapping; CMS 2027 initial file unchanged
PACE
Source verification pending
RxHCC
No category in the PY2026 CMS mapping; CMS 2027 initial file unchanged
HHS-HCC
No category in the HHS-HCC 2026 benefit year mapping
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Source: M00-M99 (chapter, inherited).
Excludes2
arthropathic psoriasis (L40.5-)
Source: M00-M99 (chapter, inherited).
Excludes2
certain conditions originating in the perinatal period (P04-P96)
Source: M00-M99 (chapter, inherited).
Excludes2
certain infectious and parasitic diseases (A00-B99)
Source: M00-M99 (chapter, inherited).
Excludes2
compartment syndrome (traumatic) (T79.A-)
Source: M00-M99 (chapter, inherited).
Excludes2
complications of pregnancy, childbirth and the puerperium (O00-O9A)
Source: M00-M99 (chapter, inherited).
Excludes2
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
Source: M00-M99 (chapter, inherited).
Excludes2
endocrine, nutritional and metabolic diseases (E00-E88)
Source: M00-M99 (chapter, inherited).
Excludes2
injury, poisoning and certain other consequences of external causes (S00-T88)
Source: M00-M99 (chapter, inherited).
Excludes2
neoplasms (C00-D49)
Source: M00-M99 (chapter, inherited).
Excludes2
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Source: M00-M99 (chapter, inherited).
Instructional note
This block comprises arthropathies due to microbiological agents. Distinction is made between the following types of etiological relationship:
Source: M00-M02 (section, inherited).
Instructional note
a) direct infection of joint, where organisms invade synovial tissue and microbial antigen is present in the joint;
Source: M00-M02 (section, inherited).
Instructional note
b) indirect infection, which may be of two types: a reactive arthropathy, where microbial infection of the body is established but neither organisms nor antigens can be identified in the joint, and a postinfective arthropathy, where microbial antigen is present but recovery of an organism is inconstant and evidence of local multiplication is lacking.
Source: M00-M02 (section, inherited).
Code first
underlying disease, such as:
Source: M02 (category, inherited).
Code first
congenital syphilis [Clutton's joints] (A50.5)
Source: M02 (category, inherited).
Code first
enteritis due to Yersinia enterocolitica (A04.6)
Source: M02 (category, inherited).
Code first
infective endocarditis (I33.0)
Source: M02 (category, inherited).
Code first
viral hepatitis (B15-B19)
Source: M02 (category, inherited).
Excludes1
Behçet's disease (M35.2)
Source: M02 (category, inherited).
Excludes1
direct infections of joint in infectious and parasitic diseases classified elsewhere (M01.-)
Source: M02 (category, inherited).
Excludes1
postmeningococcal arthritis (A39.84)
Source: M02 (category, inherited).
Excludes1
mumps arthritis (B26.85)
Source: M02 (category, inherited).
Excludes1
rubella arthritis (B06.82)
Source: M02 (category, inherited).
Excludes1
syphilis arthritis (late) (A52.77)
Source: M02 (category, inherited).
Excludes1
rheumatic fever (I00)
Source: M02 (category, inherited).
Excludes1
tabetic arthropathy [Charcôt's] (A52.16)
Source: M02 (category, inherited).
Compare the FY2027 additions, removals and billable-status changes
What does M02.219 mean in FY2027?
The official ICD-10-CM descriptor is Postimmunization arthropathy, unspecified shoulder. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is M02.219 billable in FY2027?
The FY2027 order file marks M02.219 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does M02.219 map to an HCC?
M02.219 has no CMS-HCC V28 category in the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service). Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: no ESRD category; no RxHCC category. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: no category in the HHS-HCC 2026 benefit year mapping. CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). The PACE mapping is still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.
Review the FY2026 April edition