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v1.0.0
ICD-10 Guide
ICD-10 CodesM02.231

M02.231

Billable

Postimmunization arthropathy, right wrist

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

Code Description

ICD-10 M02.231 is a billable code used to indicate a diagnosis of postimmunization arthropathy, right wrist.

Key Diagnostic Point:

Postimmunization arthropathy refers to joint pain and inflammation that occurs following vaccination. In this case, the right wrist is affected. The wrist is a complex joint composed of eight carpal bones, the radius, and the ulna, allowing for a wide range of motion. Postimmunization arthropathy can manifest as pain, swelling, and stiffness in the wrist, potentially impacting the surrounding tendons and ligaments. The pathophysiology may involve an autoimmune response triggered by the vaccine, leading to synovitis and joint effusion. Clinically, patients may present with limited range of motion, tenderness upon palpation, and signs of inflammation. Diagnosis typically involves a thorough history, physical examination, and possibly imaging studies to rule out other causes of wrist pain.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunological responses to vaccines.
  • Involves specific anatomical knowledge of the wrist joint.
  • Differentiation from other arthropathies is necessary.
  • Documentation must specify laterality and joint involvement.

Audit Risk Factors

  • Inadequate documentation of vaccination history.
  • Failure to specify laterality (right wrist).
  • Misclassification of the condition as a primary arthropathy.
  • Lack of supporting evidence for the diagnosis in the medical record.

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Orthopedic documentation should include imaging studies (e.g., X-rays, MRI) to assess joint integrity and any structural changes. Functional assessments to evaluate range of motion and strength are also critical.

Common Clinical Scenarios

Patients may present with wrist pain post-vaccination, requiring evaluation for potential surgical interventions if conservative management fails.

Billing Considerations

Documentation should detail the severity of symptoms and any functional limitations experienced by the patient.

Rheumatology

Documentation Requirements

Rheumatologic documentation should include laboratory tests for inflammatory markers (e.g., ESR, CRP) and assessments of disease activity to rule out underlying autoimmune conditions.

Common Clinical Scenarios

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

Billing Considerations

Consideration of systemic involvement and the potential for chronicity of symptoms is essential.

Physical Medicine

Documentation Requirements

Functional assessments should focus on the patient's ability to perform daily activities and any rehabilitation needs, including physical therapy referrals.

Common Clinical Scenarios

Patients may require rehabilitation for mobility limitations following postimmunization arthropathy.

Billing Considerations

Documentation should address the need for assistive devices or modifications to daily activities.

Coding Guidelines

Inclusion Criteria

Use M02.231 When
  • 10 coding guidelines require specificity in laterality (right wrist) and the need to document the encounter type (initial, subsequent, or sequela)
  • Accurate coding also necessitates a clear link between the immunization and the onset of arthropathy

Exclusion Criteria

Do NOT use M02.231 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 treatment response for postimmunization arthropathy.

Documentation Requirements

Documentation must include history of present illness, examination findings, and treatment plan.

Specialty Considerations

Orthopedic and rheumatologic considerations for ongoing management.

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. This specificity aids in better tracking of vaccine-related adverse events and improves the quality of care provided.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including postimmunization arthropathy. This specificity aids in better tracking of vaccine-related adverse events and improves the quality of care provided.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, including postimmunization arthropathy. This specificity aids in better tracking of vaccine-related adverse events and improves the quality of care provided.

Resources

Clinical References

  • •
    CDC Vaccine Adverse Event Reporting System (VAERS)

Coding & Billing References

  • •
    CDC Vaccine Adverse Event Reporting System (VAERS)

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 occurring within days to weeks after vaccination.