M08.219
BillableJuvenile rheumatoid arthritis with systemic onset, unspecified 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
A systemic form of childhood arthritis with fever and rash affecting the shoulder, but it is unclear which shoulder or both are involved.
Coding Tips
- •Use this code only when shoulder involvement is documented but laterality cannot be determined from the record
- •Query the provider if possible to determine unilateral versus bilateral involvement for more specific coding
Clinical Significance
Systemic onset juvenile rheumatoid arthritis with unspecified shoulder involvement represents severe pediatric inflammatory disease with systemic manifestations and shoulder joint arthritis. The unspecified laterality may indicate bilateral involvement or incomplete documentation, requiring clarification for optimal care coordination.
Documentation Requirements
- ✓Physician diagnosis of systemic onset juvenile rheumatoid arthritis
- ✓Documentation of shoulder joint involvement
- ✓Age of onset documented as under 16 years
- ✓Evidence of systemic features (fever, rash, organomegaly)
- ✓Shoulder function assessment (bilateral if applicable)
- ✓Laboratory evidence of systemic inflammation
- ✓Treatment with systemic immunosuppressive therapy
- ✓Clarification of unilateral versus bilateral shoulder involvement
Commonly Confused Codes
Code Hierarchy
└M08Juvenile arthritis└M08.2Juvenile rheumatoid arthritis with systemic onset└M08.21Juvenile rheumatoid arthritis with systemic onset, shoulder└M08.219Juvenile rheumatoid arthritis with systemic onset, unspecified shoulder
└M08.219Juvenile rheumatoid arthritis with systemic onset, unspecified shoulder