M08.012
BillableUnspecified juvenile rheumatoid arthritis, left shoulder
HCC Category Mapping
V28HCC 93 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.175V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.307ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000RxHCCHCC 83 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000What This Code Means
Rheumatoid arthritis in children that cannot be classified into a specific type, affecting the left shoulder.
Coding Tips
- •The fifth character '2' specifies left shoulder involvement
- •Document the patient's age and symptom onset to support juvenile classification
Clinical Significance
Unspecified juvenile rheumatoid arthritis represents a chronic inflammatory condition requiring ongoing medical management and monitoring for complications. This diagnosis significantly impacts risk adjustment as it indicates a patient with complex healthcare needs requiring specialty care, immunosuppressive medications, and potential for systemic complications.
Documentation Requirements
- ✓Patient age at onset (must be under 16 years old)
- ✓Evidence of chronic joint inflammation in left shoulder
- ✓Documentation that specific type of juvenile arthritis cannot be determined
- ✓Exclusion of other causes of arthritis
- ✓Physical examination findings of joint swelling, warmth, or limited range of motion
- ✓Laboratory results supporting inflammatory process (ESR, CRP)
- ✓Treatment response or ongoing medication management
- ✓Assessment of functional limitations or disability
Commonly Confused Codes
M08.011 — Right shoulder involvement versus left shoulderM08.019 — Unspecified shoulder laterality versus specifically documented left sideM06.9 — Adult rheumatoid arthritis versus juvenile onsetM25.512 — Joint pain versus documented inflammatory arthritisM08.1 — Juvenile ankylosing spondylitis with specific axial involvement
Code Hierarchy
└M08Juvenile arthritis└M08.0Unspecified juvenile rheumatoid arthritis└M08.01Unspecified juvenile rheumatoid arthritis, shoulder└M08.012Unspecified juvenile rheumatoid arthritis, left shoulder
└M08.012Unspecified juvenile rheumatoid arthritis, left shoulder