M86.019

Billable

Acute hematogenous osteomyelitis, unspecified shoulder

HCC Category Mapping

V28HCC 92 — Bone/Joint/Muscle Infections/Necrosis

0.209

V24HCC 39 — Bone/Joint/Muscle Infections/Necrosis

0.482

ESRDHCC 39 — Bone/Joint/Muscle Infections/Necrosis

0.000

What This Code Means

A serious bone infection of the shoulder area caused by bacteria spreading through the bloodstream, but the specific side (left or right) is not documented.

Coding Tips

•Use this code only when laterality cannot be determined from medical records
•Query the provider if possible to obtain specific laterality information for more precise coding

Clinical Significance

Acute hematogenous osteomyelitis of unspecified shoulder indicates serious bloodstream-spread bone infection when laterality is not documented, requiring immediate aggressive treatment to prevent complications. This diagnosis suggests incomplete documentation that may benefit from clarification of specific side involved for optimal care coordination.

Documentation Requirements

✓Documentation of acute osteomyelitis affecting shoulder region
✓Evidence of hematogenous spread without side specification
✓Clinical findings of shoulder involvement without laterality
✓Imaging studies showing shoulder bone infection
✓Microbiological workup with culture results
✓Treatment plan with IV antibiotics and surgical consideration
✓Absence of specific right or left shoulder documentation

Commonly Confused Codes

M86011 — Right shoulder (when laterality is known)M86012 — Left shoulder (when laterality is known)M86119 — Other acute osteomyelitis, unspecified shoulder M00.019 — Staphylococcal arthritis, unspecified shoulder M75.30 — Calcific tendinitis of unspecified shoulder

Code Hierarchy

└M86Osteomyelitis └M86.0Acute hematogenous osteomyelitis └M86.01Acute hematogenous osteomyelitis, shoulder └M86.019Acute hematogenous osteomyelitis, unspecified shoulder

└M86.019Acute hematogenous osteomyelitis, unspecified shoulder