M08.911

HCC Category Mapping

What This Code Means

A type of arthritis that develops in children, affecting the right shoulder joint. This condition causes inflammation and can lead to pain, swelling, and reduced shoulder mobility.

Coding Tips

• •Ensure right shoulder involvement is clearly documented; do not use for bilateral or left shoulder involvement
• •Verify that the arthritis is unspecified type rather than a more specific juvenile arthritis subtype

Clinical Significance

Juvenile arthritis, unspecified type, affecting the right shoulder represents chronic inflammatory disease requiring ongoing pediatric rheumatology management. This diagnosis indicates need for specialized care, immunomodulating therapy, and monitoring for functional limitations and growth impacts when specific arthritis subtype cannot be determined.

Documentation Requirements

• ✓Patient age at onset documented as under 16 years
• ✓Evidence of inflammatory arthritis specifically in right shoulder
• ✓Documentation that specific type of juvenile arthritis cannot be determined
• ✓Physical examination demonstrating shoulder joint inflammation
• ✓Laboratory studies supporting inflammatory arthritis diagnosis
• ✓Imaging studies of shoulder joint if performed
• ✓Treatment plan including appropriate disease-modifying therapy
• ✓Assessment of shoulder function and range of motion

Commonly Confused Codes