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M89.719

Billable

Major osseous defect, unspecified shoulder region

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A significant loss or defect in bone structure affecting the shoulder region when the specific side (left or right) is not documented or is bilateral.

Coding Tips

  • •Use this code only when laterality cannot be determined from the medical record; query the provider if documentation is ambiguous.
  • •If the defect is bilateral, consider coding both M89.711 and M89.712 instead of using the unspecified code.

Code Hierarchy

└M89Other disorders of bone└M89.7Major osseous defect└M89.71Major osseous defect, shoulder region└M89.719Major osseous defect, unspecified shoulder region
└M89.719Major osseous defect, unspecified shoulder region

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