ICD Code M19.012

ICD code M19.012 is used to identify and classify the diagnosis of primary osteoarthritis in the left shoulder. This code is part of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), which is used by healthcare providers to document and report diseases and health conditions. Primary osteoarthritis refers to the degenerative joint disease that occurs without a known cause, affecting the cartilage and bones of the shoulder joint, leading to pain and reduced mobility. The specificity of this code helps in accurate billing, treatment planning, and statistical analysis.

1. Chronic Joint Pain: Persistent pain in the left shoulder that worsens with activity and improves with rest, indicating a degenerative condition rather than an acute injury.

2. Stiffness: Noticeable stiffness in the left shoulder, particularly in the morning or after periods of inactivity, which gradually improves with movement.

3. Reduced Range of Motion: Difficulty in moving the left shoulder through its full range of motion, often accompanied by a feeling of grinding or catching during movement.

4. Swelling: Mild to moderate swelling around the left shoulder joint, which may fluctuate with activity levels.

5. Crepitus: Audible or palpable grinding, clicking, or popping sounds in the left shoulder during movement, suggesting cartilage wear.

6. X-ray Findings: Radiographic evidence of joint space narrowing, osteophyte formation, or subchondral sclerosis in the left shoulder, confirming degenerative changes.

7. Exclusion of Other Conditions: Rule out other potential causes of shoulder pain, such as rheumatoid arthritis, rotator cuff injuries, or referred pain from other areas.

8. Age Factor: Typically observed in middle-aged or older individuals, as primary osteoarthritis is often associated with aging and wear-and-tear of the joint.

9. Absence of Systemic Symptoms: Lack of systemic symptoms such as fever, weight loss, or fatigue, which might indicate an inflammatory or infectious process rather than a degenerative one.

For the ICD code M19.012, which pertains to primary osteoarthritis of the left shoulder, the relevant CPT codes that may be applicable for treatment include:

1. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); without ultrasound guidance.

2. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); with ultrasound guidance, with permanent recording and reporting.

3. 23410 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute.

4. 23412 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic.

5. 23420 - Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty).

6. 29806 - Arthroscopy, shoulder, surgical; capsulorrhaphy.

7. 29807 - Arthroscopy, shoulder, surgical; repair of SLAP lesion.

8. 29821 - Arthroscopy, shoulder, surgical; synovectomy, complete.

9. 29822 - Arthroscopy, shoulder, surgical; debridement, limited.

10. 29823 - Arthroscopy, shoulder, surgical; debridement, extensive.

These CPT codes are commonly associated with procedures that may be performed to treat conditions related to primary osteoarthritis of the left shoulder. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario.

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