ICD-10-CM Billable Code

M11.819

Other specified crystal arthropathies, unspecified shoulder

Clinical Classification Guidelines

Medical Intelligence & Overview

ICD-10 Code M11.819 refers to a specific type of joint inflammation caused by crystals that affects the shoulder but does not fit into more common categories like gout or pseudogout. This condition is part of a group known as crystal arthropathies, where deposits of abnormal crystals in the joints lead to pain, swelling, and limited movement.

Causes & Symptoms

Clinical Causes: Accumulation of abnormal crystals in the shoulder joint tissues Metabolic disorders that increase crystal formation, such as high levels of uric acid or calcium pyrophosphate Previous joint injuries or surgeries that alter joint chemistry Genetic predisposition to crystal formation Lifestyle factors, including diet and alcohol consumption, influencing crystal buildup

Key Symptoms: Pain in the shoulder, often worsening with movement or pressure Swelling and redness around the shoulder joint Limited range of motion or stiffness in the shoulder Warmth or tenderness over the affected area Possible sudden flare-ups with intense pain episodes Feeling of joint stiffness that may develop gradually over days

Diagnostic & Treatment

Diagnosis Path: Diagnosing this condition typically involves a combination of medical history, physical examination, and laboratory tests. Key diagnostic methods include:

Treatment Protocols: Managing crystal arthropathies affecting the shoulder usually involves approaches to relieve symptoms and prevent future flare-ups. Common strategies include:

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.

Clinical Advice & FAQs

Billing Guidance

Is M11.819 a billable ICD-10 code?
Yes, M11.819 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report M11.819?
Clinical documentation must specify the nature of Other specified crystal arthropathies, unspecified shoulder and any associated comorbidities for accurate reporting.

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