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v1.0.0
ICD-10 Guide
ICD-10 CodesM02.252

M02.252

Billable

Postimmunization arthropathy, left hip

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

Code Description

ICD-10 M02.252 is a billable code used to indicate a diagnosis of postimmunization arthropathy, left hip.

Key Diagnostic Point:

Postimmunization arthropathy refers to joint pain and inflammation that occurs following vaccination. In this case, it specifically affects the left hip joint. The hip joint is a ball-and-socket joint formed by the acetabulum of the pelvis and the head of the femur, allowing for a wide range of motion. Postimmunization arthropathy can manifest as pain, swelling, and stiffness in the affected joint, often presenting within days to weeks after vaccination. The pathophysiology may involve an autoimmune response triggered by the vaccine, leading to synovitis and subsequent joint dysfunction. Clinically, patients may experience limitations in hip flexion, extension, and weight-bearing activities, impacting their mobility and quality of life. Diagnosis typically involves a thorough clinical history, physical examination, and may include imaging studies to rule out other causes of hip pain.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of post-vaccination reactions and their implications.
  • Involves specific anatomical knowledge of the hip joint.
  • Differentiation from other arthropathies is necessary.
  • Documentation must include vaccination history and timing.

Audit Risk Factors

  • Inadequate documentation linking the vaccination to the arthropathy.
  • Failure to specify laterality (left hip) in documentation.
  • Misclassification of the condition as a primary arthropathy without vaccination history.
  • Lack of detailed clinical notes on joint function and limitations.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with hip pain post-vaccination may require surgical intervention if conservative management fails.

Billing Considerations

Orthopedic specialists should document joint-specific considerations, including any degenerative changes or pre-existing conditions.

Rheumatology

Documentation Requirements

Rheumatologic documentation should include inflammatory markers (e.g., ESR, CRP) and assessments of disease activity to evaluate the extent of the arthropathy.

Common Clinical Scenarios

Patients may present with systemic symptoms indicating a broader autoimmune response.

Billing Considerations

Rheumatologists should consider the potential for systemic involvement and monitor for progression of symptoms.

Physical Medicine

Documentation Requirements

Functional assessments should detail the patient's mobility limitations and rehabilitation needs, including any assistive devices required.

Common Clinical Scenarios

Rehabilitation may focus on restoring hip function and improving quality of life through physical therapy.

Billing Considerations

Documenting the patient's ability to perform activities of daily living is crucial for rehabilitation planning.

Coding Guidelines

Inclusion Criteria

Use M02.252 When
  • 10 coding guidelines require specificity in laterality (left hip) and documentation of the encounter type (initial, subsequent, or sequela)
  • It is essential to document the timing of the vaccination in relation to the onset of symptoms

Exclusion Criteria

Do NOT use M02.252 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

20610CPT Code

Arthrocentesis, aspiration and/or injection into a major joint or bursa

Clinical Scenario

Used for therapeutic injection in the left hip to relieve pain and inflammation.

Documentation Requirements

Document the indication for the procedure, including the diagnosis of postimmunization arthropathy.

Specialty Considerations

Orthopedic and rheumatologic specialists may perform this procedure.

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 reactions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of postimmunization reactions and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of postimmunization reactions and their management.

Resources

Clinical References

  • •
    CDC Immunization Guidelines

Coding & Billing References

  • •
    CDC Immunization Guidelines

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 joint, typically presenting within days to weeks after vaccination.