2026 ICD-10-CM Diagnosis Code M12.811Other specific arthropathies, not elsewhere classified, right shoulder

ICD-10-CM Codes›M00–M99›M05-M14›M12

ICD-10-CM M12.811
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M12.811 is a billable ICD-10-CM diagnosis code for other specific arthropathies, not elsewhere classified, right shoulder. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 553 through 554. Coders also document this condition as bilateral arthropathy of joint of shoulder regions. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified joint disorders.

Code Identity

ICD-10-CM Code
M12.811
Billable Status
Yes — Valid for Submission
Code Describes
Other specific arthropathies, not elsewhere classified, right shoulder
Short Description
Oth specific arthropathies, NEC, right shoulder
Parent Code
M12.81
Other specific arthropathies, not elsewhere classified, shoulder

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM05-M14Inflammatory polyarthropathies
CategoryM12Other and unspecified arthropathy
This CodeM12.811Other specific arthropathies, not elsewhere classified, right shoulder

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Bilateral arthropathy of joint of shoulder regions
  • Hemophilic arthropathy of right shoulder

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MUS007
Other specified joint disorders
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Shoulder Injuries and Disorders

Your shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). Your shoulders are the most movable joints in your body. They can also be unstable because the ball of the upper arm is larger than the shoulder socket that holds it.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert M12.811 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
716.41 Trans arthropathy-shlder
Approximate The match is approximate rather than exact.
ICD-9-CM
716.81 Arthropathy NEC-shlder
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M12.811Overview

Is M12.811 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report other specific arthropathies, not elsewhere classified, right shoulder on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does M12.811 group to?

When other specific arthropathies, not elsewhere classified, right shoulder is the principal diagnosis on an inpatient stay, it groups to MS-DRG 553, 554, with relative weights from 0.8301 to 1.2963 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of M12.811?

Under the General Equivalence Mappings, other specific arthropathies, not elsewhere classified, right shoulder converts to ICD-9-CM 716.41 (trans arthropathy-shlder) and 716.81 (arthropathy NEC-shlder). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.