M25.119
BillableFistula, unspecified shoulder
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
An abnormal tunnel or opening in the shoulder joint when it's unclear which side (left or right) is affected.
Coding Tips
- •Use this code only when laterality cannot be determined from documentation; query the provider if possible for clarification
- •This is a less specific code; attempt to determine right vs left shoulder for more precise coding
Code Hierarchy
└M25Other joint disorder, not elsewhere classified└M25.1Fistula of joint└M25.11Fistula, shoulder└M25.119Fistula, unspecified shoulder
└M25.119Fistula, unspecified shoulder