2027 ICD-10-CM Diagnosis Code M12.311Palindromic rheumatism, right shoulder
ICD-10-CM Codes›M00–M99›M05-M14›M12
- Billable — Valid for Submission
- Chronic Condition
M12.311 is a billable ICD-10-CM diagnosis code for palindromic rheumatism, right shoulder. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 553 through 554. Coders also document this condition as palindromic rheumatism of joint of bilateral shoulder regions. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified joint disorders.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Palindromic rheumatism of joint of bilateral shoulder regions
- Palindromic rheumatism of joint of left shoulder region
- Palindromic rheumatism of joint of right shoulder region
- Palindromic rheumatism of shoulder region
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M12.311: its own notes plus those printed at M12, block M00-M25, and Chapter 13. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- Disorders affecting predominantly peripheral (limb) joints
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name M12.311, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming M12.311: they are not reported together with it, unless the two conditions are unrelated.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Palindromic Rheumatism
a condition characterized by flares of arthritis with remission in between episodes. single or multiple joints may be affected as well as the periarticular soft tissues.
Patient EducationClinical
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, and stiffness in your joints. RA is an autoimmune disease. Although it is most common in the wrist and fingers, this disease can cause your immune system to attack any joint tissue. The inflammation (swelling) that comes with RA can also affect other body parts.
The full article covers:
- What is rheumatoid arthritis?
- Who is more likely to get rheumatoid arthritis?
- What causes rheumatoid arthritis?
- What are the symptoms of rheumatoid arthritis?
- How is rheumatoid arthritis diagnosed?
- What are the treatments for rheumatoid arthritis?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M12.311 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M12.311Overview
What is the ICD-10 code for palindromic rheumatism, right shoulder?
The ICD-10-CM code for palindromic rheumatism, right shoulder is M12.311 (sometimes written as M12311). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is M12.311 (Palindromic rheumatism, shoulder) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report palindromic rheumatism, right shoulder on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does M12.311 group to?
When palindromic rheumatism, right shoulder is the principal diagnosis on an inpatient stay, it groups to MS-DRG 554, 553, with relative weights from 0.8328 to 1.2492 depending on complications. Higher weights mean higher Medicare reimbursement.
Can M12.311 be reported with J38.7?
Not as a rule. The Excludes1 note at M12, which applies to M12.311, lists "cricoarytenoid arthropathy (J38.7)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of M12.311?
Under the General Equivalence Mappings, palindromic rheumatism, right shoulder converts to ICD-9-CM 719.31 (palindrom rheum-shlder). The mapping is approximate, so confirm the match fits the documentation.
