M86.612

Billable

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

Coding Tips

•Ensure left shoulder is clearly documented to differentiate from right-sided infection
•Verify this is chronic osteomyelitis rather than acute infection

Clinical Significance

Chronic osteomyelitis of the left shoulder represents a persistent bone infection that severely compromises upper extremity function and quality of life. This condition often requires prolonged antibiotic therapy and may necessitate surgical intervention, significantly impacting the patient's ability to perform work and daily activities.

Documentation Requirements

✓Confirmation of chronic nature (minimum 6 weeks duration or recurrent)
✓Specific documentation of left shoulder bone involvement
✓Non-hematogenous etiology (contiguous spread or direct inoculation)
✓Radiographic evidence of bone infection or osteomyelitic changes
✓Laboratory studies supporting chronic infection process
✓Functional assessment of left shoulder and upper extremity
✓Documentation of antibiotic therapy and surgical procedures
✓Assessment of occupational and functional limitations

Commonly Confused Codes

M86.512 — Other chronic hematogenous osteomyelitis, left shoulder (hematogenous origin)M86.611 — Other chronic osteomyelitis, right shoulder (opposite side)M86.412 — Chronic osteomyelitis with draining sinus, left shoulder (has sinus tract)M86.112 — Other acute osteomyelitis, left shoulder (acute presentation)M75.32 — Calcific tendinitis of left shoulder (soft tissue condition)

Code Hierarchy

└M86Osteomyelitis └M86.6Other chronic osteomyelitis └M86.61Other chronic osteomyelitis, shoulder └M86.612Other chronic osteomyelitis, left shoulder

└M86.612Other chronic osteomyelitis, left shoulder