M12.511
M12.511: Traumatic arthropathy, right shoulder
Billable / specific codeICD-10-CMright
M12.511 is a billable, specific ICD-10-CM code for traumatic arthropathy, right shoulder. It is valid for submission on a claim.
Check M12.511 with the rest of the claim: free scrubberExcludes1 inherited from the categories above M12.511
A category’s note binds every code beneath it.
Written on M12.5: Traumatic arthropathy
- current injury-see Alphabetic Index
- post-traumatic osteoarthritis of first carpometacarpal joint (M18.2-M18.3)
- post-traumatic osteoarthritis of hip (M16.4-M16.5)
- post-traumatic osteoarthritis of knee (M17.2-M17.3)
- post-traumatic osteoarthritis NOS (M19.1-)
- post-traumatic osteoarthritis of other single joints (M19.1-)
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
M12.511 is named in 12 Medicare coverage policies: 5 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
Code history
Unchanged in every release from FY2024 to FY2027.