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ICD-10 Guide
ICD-10 CodesM02.319

M02.319

Billable

Reiter's disease, unspecified shoulder

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

Code Description

ICD-10 M02.319 is a billable code used to indicate a diagnosis of reiter's disease, unspecified shoulder.

Key Diagnostic Point:

Reiter's disease, also known as reactive arthritis, is a type of inflammatory arthritis that develops in response to an infection in another part of the body. It is characterized by the classic triad of arthritis, urethritis, and conjunctivitis, although not all patients exhibit all three symptoms. In the case of unspecified shoulder involvement, the patient may experience pain, swelling, and stiffness in the shoulder joint, which can limit range of motion and functional capacity. Anatomically, the shoulder consists of the humerus, scapula, and clavicle, with the glenohumeral joint being the primary site of movement. Pathophysiologically, Reiter's disease is believed to be an autoimmune response triggered by infections, often of the genitourinary or gastrointestinal tract. Clinically, patients may present with acute onset of shoulder pain, tenderness, and swelling, often accompanied by systemic symptoms such as fever and malaise. Early diagnosis and management are crucial to prevent chronic joint damage and functional impairment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptomatology
  • Need for comprehensive documentation of joint involvement
  • Potential overlap with other inflammatory arthritides
  • Importance of capturing associated systemic symptoms

Audit Risk Factors

  • Inadequate documentation of joint involvement
  • Failure to specify laterality or severity
  • Misclassification of Reiter's disease as another type of arthritis
  • Lack of supporting evidence for associated systemic symptoms

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 and strength.

Common Clinical Scenarios

Common scenarios include acute shoulder pain following a recent infection, requiring surgical intervention for joint debridement or synovectomy.

Billing Considerations

Joint-specific considerations include documenting the severity of joint effusion and any structural changes observed in imaging.

Rheumatology

Documentation Requirements

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

Common Clinical Scenarios

Patients may present with a history of urethritis or conjunctivitis preceding shoulder symptoms, necessitating a thorough review of systemic involvement.

Billing Considerations

Consideration of extra-articular manifestations and the potential for chronicity in disease progression is essential.

Physical Medicine

Documentation Requirements

Functional assessments should evaluate the patient's ability to perform daily activities and any rehabilitation needs for mobility restoration.

Common Clinical Scenarios

Rehabilitation scenarios may involve physical therapy for shoulder range of motion and strength training following acute inflammatory episodes.

Billing Considerations

Documentation should address mobility limitations and the need for assistive devices to enhance functional independence.

Coding Guidelines

Inclusion Criteria

Use M02.319 When
  • 10 coding guidelines require specificity in laterality (e
  • , left, right, bilateral) and severity of the condition
  • Encounter type (initial, subsequent, sequela) must also be documented appropriately

Exclusion Criteria

Do NOT use M02.319 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 patients with significant shoulder effusion due to Reiter's disease.

Documentation Requirements

Document the indication for the procedure, joint accessed, and any fluid analysis performed.

Specialty Considerations

Orthopedic considerations include assessing joint stability and potential need for further intervention.

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 disease prevalence and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of disease prevalence and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for greater specificity in coding musculoskeletal conditions, enabling better tracking of disease prevalence and treatment outcomes.

Resources

Clinical References

  • •
    American College of Rheumatology Guidelines

Coding & Billing References

  • •
    American College of Rheumatology Guidelines

Frequently Asked Questions

What are the common symptoms of Reiter's disease?

Common symptoms include joint pain and swelling, particularly in the knees and shoulders, along with possible urethritis and conjunctivitis. Patients may also experience systemic symptoms such as fever and fatigue.