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M19.011 vs M19.012

M19.011 (Primary osteoarthritis, right shoulder) compared with M19.012 (Primary osteoarthritis, left shoulder), from the official CMS tabular data. M19.011 and M19.012 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

M19.011
Right
Primary osteoarthritis, right shoulder
M19.012
Left
Primary osteoarthritis, left shoulder

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. M19.011 and M19.012 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

M19.011Primary osteoarthritis, right shoulderM19.012Primary osteoarthritis, left shoulder
Billing statusBillableBillable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionPrimary osteoarthritis, right shoulder is a billable ICD-10-CM diagnosis code (M19.011).Primary osteoarthritis, left shoulder is a billable ICD-10-CM diagnosis code (M19.012).

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources