M06.811

Billable

Other specified rheumatoid arthritis, right 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 form of rheumatoid arthritis with unusual or atypical features affecting the right shoulder joint.

Coding Tips

•This code specifies right shoulder involvement; use M06.812 for left shoulder and M06.819 when laterality is unspecified
•Document the specific atypical features or manifestations that distinguish this from classic rheumatoid arthritis

Clinical Significance

Other specified rheumatoid arthritis affecting the right shoulder indicates an atypical variant of RA in a joint crucial for upper extremity function and activities of daily living. Shoulder involvement can significantly impact occupational activities and self-care capabilities.

Documentation Requirements

✓Confirmed rheumatoid arthritis diagnosis with specific atypical features
✓Clinical examination documenting right shoulder involvement specifically
✓Description of atypical characteristics distinguishing from standard RA
✓Assessment of shoulder range of motion and functional limitations
✓Laboratory findings consistent with rheumatoid disease process
✓Impact on activities of daily living and occupational function
✓Treatment response and current management approach
✓Imaging studies of right shoulder when available

Commonly Confused Codes

M06.812 — Other specified rheumatoid arthritis, left shoulder (incorrect laterality)M06.819 — Other specified rheumatoid arthritis, unspecified shoulder (when laterality documented)M05.811 — Other rheumatoid arthritis with rheumatoid factor of right shoulder (when RF status determines coding)M25.511 — Pain in right shoulder (symptom without inflammatory disease)M75.31 — Calcific tendinitis of right shoulder (different shoulder pathology)

Code Hierarchy

└M06Other rheumatoid arthritis └M06.8Other specified rheumatoid arthritis └M06.81Other specified rheumatoid arthritis, shoulder └M06.811Other specified rheumatoid arthritis, right shoulder

└M06.811Other specified rheumatoid arthritis, right shoulder