ICD-10-CM Billable Code

M00.11

Pneumococcal arthritis, shoulder

Clinical Classification Guidelines

Medical Intelligence & Overview

Pneumococcal arthritis of the shoulder is a bacterial infection caused by Streptococcus pneumoniae bacteria, affecting the shoulder joint. This condition leads to inflammation, pain, and swelling in the shoulder area. It is a serious medical condition that requires prompt attention to prevent joint damage and other complications. Recognizing the symptoms and understanding the causes can help in seeking timely medical care.

Causes & Symptoms

Clinical Causes: Infection by Streptococcus pneumoniae bacteria, which can spread from other parts of the body or through a bloodstream infection. Spread from nearby infected tissues or wounds. Physical injury or trauma to the shoulder that provides an entry point for bacteria. Pre-existing health conditions that weaken the immune system, such as diabetes or chronic illnesses. Invasive medical procedures involving the shoulder or joint replacement surgery.

Key Symptoms: Severe pain in the shoulder that worsens with movement. Swelling and tenderness around the shoulder joint. Limited range of motion due to pain or swelling. Redness and warmth over the affected shoulder area. Fever and chills, indicating systemic infection. General malaise and feeling unwell.

Diagnostic & Treatment

Diagnosis Path: Diagnosing pneumococcal arthritis involves several steps:

Treatment Protocols: Treatment aims to eliminate the infection, reduce inflammation, and preserve joint function:

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 M00.11 a billable ICD-10 code?
Yes, M00.11 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.

Documentation

How do I report M00.11?
Clinical documentation must specify the nature of Pneumococcal arthritis, shoulder and any associated comorbidities for accurate reporting.

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