M86.412

Billable

Chronic osteomyelitis with draining sinus, left 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 chronic bone infection of the left shoulder with an open drainage tract or sinus that allows infected material to drain to the skin surface.

Coding Tips

•Confirm the draining sinus is documented in clinical notes or imaging findings
•Verify laterality is documented as 'left' before code assignment

Clinical Significance

This diagnosis captures chronic osteomyelitis with draining sinus of the left shoulder, a complex condition combining persistent bone infection with active drainage requiring specialized treatment. The shoulder's critical role in upper extremity function makes this condition particularly disabling and challenging to manage.

Documentation Requirements

✓Clear documentation of left shoulder involvement
✓Evidence supporting chronic nature (duration >6 weeks or recurrent)
✓Confirmation of active draining sinus tract
✓Imaging studies demonstrating chronic osteomyelitic changes
✓Clinical assessment of shoulder function and drainage
✓Laboratory findings consistent with chronic infection
✓Treatment documentation for both infection and drainage management
✓Provider correlation with chronic osteomyelitis with draining sinus

Commonly Confused Codes

M86.512 — Other chronic hematogenous osteomyelitis, left shoulder, no drainage M86.411 — Same condition but right-sided shoulder M86.312 — Chronic multifocal osteomyelitis, left shoulder, no drainage M86.112 — Acute osteomyelitis of left shoulder, acute presentation L02.212 — Cutaneous abscess of left shoulder, superficial infection

Code Hierarchy

└M86Osteomyelitis └M86.4Chronic osteomyelitis with draining sinus └M86.41Chronic osteomyelitis with draining sinus, shoulder └M86.412Chronic osteomyelitis with draining sinus, left shoulder

└M86.412Chronic osteomyelitis with draining sinus, left shoulder