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v1.0.0
ICD-10 Guide
ICD-10 CodesM02.249

M02.249

Billable

Postimmunization arthropathy, unspecified hand

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

Code Description

ICD-10 M02.249 is a billable code used to indicate a diagnosis of postimmunization arthropathy, unspecified hand.

Key Diagnostic Point:

Postimmunization arthropathy refers to joint pain and inflammation that occurs following vaccination. This condition can affect the hand, leading to symptoms such as swelling, stiffness, and pain in the joints of the fingers and wrist. Anatomically, the hand consists of multiple joints including the metacarpophalangeal joints, proximal interphalangeal joints, and distal interphalangeal joints, all of which can be involved. The pathophysiology may involve an autoimmune response triggered by the vaccine, leading to synovitis and subsequent arthralgia. Clinically, patients may present with limited range of motion, tenderness upon palpation, and potential swelling. The condition is typically self-limiting, but it can cause significant discomfort and functional impairment during its course.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Potential overlap with other inflammatory arthropathies
  • Need for thorough documentation of vaccination history
  • Differentiation from other causes of hand pain

Audit Risk Factors

  • Inadequate documentation of vaccination history
  • Failure to specify laterality of symptoms
  • Lack of detailed clinical notes on joint examination
  • Misclassification with other arthropathies

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (e.g., X-rays, MRIs) to rule out other conditions, as well as functional assessments to evaluate joint mobility.

Common Clinical Scenarios

Patients may present with acute onset of hand pain following vaccination, requiring assessment for potential surgical intervention if conservative measures fail.

Billing Considerations

Joint-specific considerations include documenting the severity of symptoms and any impact on daily activities.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients may exhibit systemic symptoms alongside localized joint pain, necessitating a comprehensive evaluation for autoimmune conditions.

Billing Considerations

Consideration of systemic involvement is crucial, as postimmunization arthropathy may mimic other rheumatologic disorders.

Physical Medicine

Documentation Requirements

Functional assessments should be documented to evaluate the patient's ability to perform daily activities and any rehabilitation needs.

Common Clinical Scenarios

Patients may require physical therapy to regain strength and mobility in the hand following an episode of arthropathy.

Billing Considerations

Mobility limitations should be clearly documented, including any need for assistive devices.

Coding Guidelines

Inclusion Criteria

Use M02.249 When
  • Official coding guidelines require documentation of laterality (e
  • , right or left hand) and severity of symptoms
  • Encounter type (initial, follow
  • up) should also be documented to ensure accurate coding

Exclusion Criteria

Do NOT use M02.249 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 ongoing symptoms and treatment efficacy.

Documentation Requirements

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

Specialty Considerations

Orthopedic and rheumatologic considerations for joint assessment.

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, enabling better tracking of postimmunization arthropathy and its outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of postimmunization arthropathy and its outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of postimmunization arthropathy and its outcomes.

Resources

Clinical References

  • •
    American Academy of Orthopaedic Surgeons Guidelines
  • •
    American College of Rheumatology Recommendations

Coding & Billing References

  • •
    American Academy of Orthopaedic Surgeons Guidelines
  • •
    American College of Rheumatology Recommendations

Frequently Asked Questions

What are the common symptoms of postimmunization arthropathy?

Common symptoms include joint pain, swelling, stiffness, and limited range of motion in the affected joints, typically presenting within days to weeks following vaccination.