M06.812

Billable

Other specified rheumatoid arthritis, left 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 left shoulder joint.

Coding Tips

•Verify left shoulder involvement in documentation before assigning this code; confirm it is not bilateral
•Consider documenting functional limitations related to shoulder involvement, such as reduced range of motion or pain with movement

Clinical Significance

Other specified rheumatoid arthritis of the left shoulder represents an atypical RA variant affecting a joint essential for upper extremity function, self-care, and occupational activities. Left shoulder involvement may be particularly limiting for dominant-hand individuals.

Documentation Requirements

✓Established rheumatoid arthritis diagnosis with documented atypical features
✓Physical examination confirming left shoulder involvement
✓Specific characteristics that classify this as 'other specified' RA type
✓Functional assessment of left shoulder range of motion and strength
✓Laboratory evidence supporting active rheumatoid disease
✓Documentation of handedness and occupational impact when relevant
✓Current treatment regimen and response to therapy
✓Imaging findings of left shoulder joint when available

Commonly Confused Codes

M06.811 — Other specified rheumatoid arthritis, right shoulder (incorrect laterality)M06.819 — Other specified rheumatoid arthritis, unspecified shoulder (when left side documented)M05.812 — Other rheumatoid arthritis with rheumatoid factor of left shoulder (different RA classification)M25.512 — Pain in left shoulder (symptom code without inflammatory diagnosis)M75.32 — Calcific tendinitis of left shoulder (non-rheumatoid shoulder condition)

Code Hierarchy

└M06Other rheumatoid arthritis └M06.8Other specified rheumatoid arthritis └M06.81Other specified rheumatoid arthritis, shoulder └M06.812Other specified rheumatoid arthritis, left shoulder

└M06.812Other specified rheumatoid arthritis, left shoulder