M06.319

Billable

Rheumatoid nodule, unspecified shoulder

HCC Category Mapping

V28HCC 93 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.175

V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.307

ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.000

RxHCCHCC 83 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease

0.000

What This Code Means

A firm lump under the skin on the shoulder caused by rheumatoid arthritis, side not specified.

Coding Tips

•Use this code only when shoulder involvement is documented but laterality cannot be determined
•Query the provider if laterality is not documented to allow for more specific coding

Clinical Significance

Rheumatoid nodule at unspecified shoulder indicates extraarticular RA manifestation when laterality is not documented. These nodules suggest more severe, typically seropositive rheumatoid disease requiring comprehensive management.

Documentation Requirements

✓Established rheumatoid arthritis diagnosis
✓Physical examination confirming shoulder nodule presence
✓Documentation that laterality is unknown or bilateral
✓Nodule characteristics and examination findings
✓Assessment of shoulder function and range of motion
✓Laboratory confirmation of RA diagnosis
✓Disease activity assessment and monitoring
✓Systemic RA treatment documentation

Commonly Confused Codes

M06.311 — Right shoulder when laterality is actually documented M06.312 — Left shoulder when laterality is actually documented M06.30 — Unspecified site when shoulder location is known M75.9 — Unspecified shoulder lesion without RA connection

Code Hierarchy

└M06Other rheumatoid arthritis └M06.3Rheumatoid nodule └M06.31Rheumatoid nodule, shoulder └M06.319Rheumatoid nodule, unspecified shoulder

└M06.319Rheumatoid nodule, unspecified shoulder