M86.411
BillableChronic osteomyelitis with draining sinus, right shoulder
HCC Category Mapping
V28HCC 92 — Bone/Joint/Muscle Infections/Necrosis
0.209V24HCC 39 — Bone/Joint/Muscle Infections/Necrosis
0.482ESRDHCC 39 — Bone/Joint/Muscle Infections/Necrosis
0.000What This Code Means
A chronic bone infection of the right shoulder with an open drainage tract or sinus that allows infected material to drain to the skin surface.
Coding Tips
- •Verify documentation confirms both chronic osteomyelitis AND presence of draining sinus
- •Ensure laterality is specified as 'right' in the medical record
Clinical Significance
Chronic osteomyelitis with draining sinus of the right shoulder represents a severe, treatment-resistant bone infection with persistent drainage, significantly impacting upper extremity function. The presence of a draining sinus indicates advanced disease requiring aggressive management and monitoring for complications.
Documentation Requirements
- ✓Specific documentation of right shoulder involvement
- ✓Evidence of chronic osteomyelitis (>6 weeks or recurrent)
- ✓Confirmation of active draining sinus tract
- ✓Radiographic findings showing chronic bone changes
- ✓Clinical description of drainage characteristics
- ✓Laboratory markers supporting chronic infection
- ✓Treatment history addressing infection and drainage management
- ✓Provider assessment confirming chronic osteomyelitis with drainage
Commonly Confused Codes
M86.511 — Other chronic hematogenous osteomyelitis, right shoulder, lacks drainageM86.412 — Same condition affecting left shoulderM86.311 — Chronic multifocal osteomyelitis, right shoulder, lacks drainageM86.111 — Acute osteomyelitis of right shoulder, acute vs chronicL02.211 — Cutaneous abscess of right shoulder, superficial vs bone
Code Hierarchy
└M86Osteomyelitis└M86.4Chronic osteomyelitis with draining sinus└M86.41Chronic osteomyelitis with draining sinus, shoulder└M86.411Chronic osteomyelitis with draining sinus, right shoulder
└M86.411Chronic osteomyelitis with draining sinus, right shoulder