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ICD-10 Guide
ICD-10 CodesM02.222

M02.222

Billable

Postimmunization arthropathy, left elbow

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/12/2025

Code Description

ICD-10 M02.222 is a billable code used to indicate a diagnosis of postimmunization arthropathy, left elbow.

Key Diagnostic Point:

Postimmunization arthropathy refers to joint pain and inflammation that occurs following vaccination. In the case of the left elbow, this condition may manifest as swelling, tenderness, and limited range of motion in the elbow joint. The elbow is a hinge joint formed by the humerus, radius, and ulna, allowing for flexion and extension. The pathophysiology involves an immune-mediated response triggered by the vaccine, leading to synovial inflammation and potential damage to the cartilage and surrounding soft tissues. Clinically, patients may present with pain exacerbated by movement, stiffness, and possible swelling. The onset of symptoms typically occurs within days to weeks post-vaccination, and while self-limiting in many cases, some patients may require further intervention if symptoms persist.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunological responses to vaccines
  • Involves specific anatomical knowledge of the elbow joint
  • Differentiation from other forms of arthropathy
  • Documentation of post-vaccination timeline and symptoms

Audit Risk Factors

  • Inadequate documentation of vaccination history
  • Failure to specify laterality of the condition
  • Misclassification of the arthropathy type
  • Lack of supporting clinical evidence for the diagnosis

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (e.g., X-rays, MRI) to assess joint integrity and functional assessments to evaluate range of motion and strength.

Common Clinical Scenarios

Common scenarios include post-vaccination pain management, evaluation for potential surgical intervention if conservative measures fail, and rehabilitation protocols.

Billing Considerations

Joint-specific considerations include assessing for any structural damage or chronic changes due to inflammation.

Rheumatology

Documentation Requirements

Rheumatologic documentation should include laboratory tests for inflammatory markers (e.g., ESR, CRP) and assessments of disease activity.

Common Clinical Scenarios

Scenarios may involve distinguishing postimmunization arthropathy from other autoimmune conditions that could mimic similar symptoms.

Billing Considerations

Consideration of systemic involvement and monitoring for any progression of symptoms is crucial.

Physical Medicine

Documentation Requirements

Functional assessments should document the patient's mobility limitations and any assistive devices used.

Common Clinical Scenarios

Rehabilitation scenarios may include physical therapy to restore range of motion and strength in the affected elbow.

Billing Considerations

Focus on mobility limitations and the need for adaptive strategies in daily activities.

Coding Guidelines

Inclusion Criteria

Use M02.222 When
  • 10 coding guidelines require documentation of laterality (left elbow), severity of symptoms, and the encounter type (initial, subsequent, or sequela)
  • Accurate coding also necessitates a clear link between the vaccination and the onset of arthropathy

Exclusion Criteria

Do NOT use M02.222 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits to assess postimmunization arthropathy symptoms.

Documentation Requirements

Documentation should include history of present illness, review of systems, and physical examination findings.

Specialty Considerations

Orthopedic and rheumatologic considerations for comprehensive evaluation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including postimmunization arthropathy, which aids in better tracking and management of these cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including postimmunization arthropathy, which aids in better tracking and management of these cases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including postimmunization arthropathy, which aids in better tracking and management of these cases.

Resources

Clinical References

  • •
    CDC Immunization Guidelines
  • •
    American Academy of Orthopaedic Surgeons (AAOS) Guidelines

Coding & Billing References

  • •
    CDC Immunization Guidelines
  • •
    American Academy of Orthopaedic Surgeons (AAOS) Guidelines

Frequently Asked Questions

What are the common symptoms of postimmunization arthropathy?

Common symptoms include joint pain, swelling, stiffness, and limited range of motion, typically occurring within days to weeks after vaccination.