M86.611

Billable

Other chronic osteomyelitis, right 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 long-term bone infection in the right shoulder area.

Coding Tips

•Confirm right shoulder is the documented site of infection
•Distinguish from hematogenous osteomyelitis by verifying the infection origin in documentation

Clinical Significance

Chronic osteomyelitis of the right shoulder represents a persistent bone infection that significantly impacts upper extremity function and activities of daily living. The shoulder's complex anatomy and critical role in arm mobility make this condition particularly debilitating, often requiring specialized orthopedic management and extended rehabilitation.

Documentation Requirements

✓Documentation of chronic duration (>6 weeks or recurrent episodes)
✓Specific involvement of right shoulder bones (humerus, scapula, or clavicle)
✓Non-hematogenous etiology (contiguous spread or direct inoculation)
✓Imaging studies showing bone infection or destruction
✓Laboratory evidence of infection or inflammatory response
✓Assessment of shoulder range of motion and functional limitations
✓Documentation of treatment including antibiotics and surgical interventions
✓Evaluation of impact on activities of daily living

Commonly Confused Codes

M86.511 — Other chronic hematogenous osteomyelitis, right shoulder (hematogenous origin)M86.612 — Other chronic osteomyelitis, left shoulder (different laterality)M86.411 — Chronic osteomyelitis with draining sinus, right shoulder (has sinus)M86.111 — Other acute osteomyelitis, right shoulder (acute phase)M75.31 — Calcific tendinitis of right shoulder (tendon pathology, not bone)

Code Hierarchy

└M86Osteomyelitis └M86.6Other chronic osteomyelitis └M86.61Other chronic osteomyelitis, shoulder └M86.611Other chronic osteomyelitis, right shoulder

└M86.611Other chronic osteomyelitis, right shoulder