M00.219 Other streptococcal arthritis, unspecified shoulder

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from M00 Pyogenic arthritis

Excludes2 (not included here)

• infection and inflammatory reaction due to internal joint prosthesis (T84.5-)

Applies from M00.2 Other streptococcal arthritis and polyarthritis

Use additional code

• code (B95.0-B95.2, B95.4-B95.5) to identify bacterial agent

Risk adjustment (HCC)

• CMS-HCC V28: HCC 92 — Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
• CMS-HCC V22: HCC 39 — Bone/Joint/Muscle Infections/Necrosis
• ESRD V24: HCC 39

MS-DRG index

Defines the logic of DRG(s) 548-550 in MDC 08.

Approximate ICD-9-CM (GEMs)

• 041.09 Streptococcus infection in conditions classified elsewhere and of unspecified site, other streptococcus (approximate)
• 711.01 Pyogenic arthritis, shoulder region (approximate)
• 711.01 Pyogenic arthritis, shoulder region (approximate)

Medicare Code Edits (MCE v43.1 (April 2026))

• Unspecified code (laterality): Unspecified codes for which a more specific code identifying laterality (right, left, bilateral) exists within the same code family.

Nearby codes

• M00.2 Other streptococcal arthritis and polyarthritis
• M00.20 Other streptococcal arthritis, unspecified joint
• M00.21 Other streptococcal arthritis, shoulder
• M00.211 Other streptococcal arthritis, right shoulder
• M00.212 Other streptococcal arthritis, left shoulder
• M00.219 Other streptococcal arthritis, unspecified shoulder (this code)
• M00.22 Other streptococcal arthritis, elbow
• M00.221 Other streptococcal arthritis, right elbow
• M00.222 Other streptococcal arthritis, left elbow
• M00.229 Other streptococcal arthritis, unspecified elbow
• M00.23 Other streptococcal arthritis, wrist