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M19.019

Billable

Primary osteoarthritis, unspecified shoulder

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Wear and tear arthritis of the shoulder joint when the specific side (left or right) is not documented or is bilateral.

Coding Tips

  • Use only when laterality cannot be determined from documentation
  • Query provider if documentation indicates bilateral involvement to assign both M19.011 and M19.012 instead

Code Hierarchy

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