M00.11 ICD-10-CM Code: Pneumococcal arthritis, shoulder

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M00.11 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on M00.11 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for M00.11

MedCoder structured workflow — derived from this code’s own official record

Before you code M00.11

1. M00.11 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

   ReviewM00.111, M00.112, M00.119

   See the relationships section · Guide: How to choose an ICD-10-CM code →

Choose the right path

1. Does the documentation support one of the more specific codes beneath M00.11?
   Yes → Select that code and continue the checks below on its own page.
   No → M00.11 cannot be reported as written; query for the specificity its subcategory needs.

   ReviewM00.111, M00.112, M00.119

Consider M00.11. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

• Excludes2 — not part of M00.11(1 note)

  Coding workflow: The conditions named in this note are not included in M00.11. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareT84.5

  See the official tabular notes · Guidelines I.A.12.b

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse M00.11 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of M00.11 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• M00.10— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Pneumococcal arthritis, unspecified joint” takes M00.10; specificity in the record moves it back here.

  Full comparison: M00.11 vs M00.10 →

• T84.5— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of infection and inflammatory reaction due to internal joint prosthesis adds T84.5; it is not part of this code and both may be reported when both are documented.

  Full comparison: M00.11 vs T84.5 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• Not billable as written — a more specific code is required: M00.111, M00.112, M00.119.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Arthritis, arthritic”; these codes share that main term but sit in a different category of the Tabular List.

E85.4 — Organ-limited amyloidosis (in, amyloidosis), E88.9 — Metabolic disorder, unspecified (in, metabolic disorder NEC), G95.0 — Syringomyelia and syringobulbia (in, syringomyelia), G98.0 — Neurogenic arthritis, not elsewhere classified (in, neurological disorder NEC), J98.9 — Respiratory disorder, unspecified (in, respiratory disorder NEC), L40.50 — Arthropathic psoriasis, unspecified (psoriatic), L40.52 — Psoriatic arthritis mutilans (mutilans), L40.54 — Psoriatic juvenile arthropathy (juvenile, psoriatic), L51.9 — Erythema multiforme, unspecified (in, erythema, multiforme), L52 — Erythema nodosum (in, erythema, nodosum), M04.1 — Periodic fever syndromes (in, Mediterranean fever, familial), M05.70 — Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement (rheumatoid, seropositive, without organ involvement), M05.71 — Rheumatoid arthritis with rheumatoid factor of shoulder without organ or systems involvement (rheumatoid, seropositive, without organ involvement, shoulder), M05.72 — Rheumatoid arthritis with rheumatoid factor of elbow without organ or systems involvement (rheumatoid, seropositive, without organ involvement, elbow), M05.73 — Rheumatoid arthritis with rheumatoid factor of wrist without organ or systems involvement (rheumatoid, seropositive, without organ involvement, wrist), M05.74 — Rheumatoid arthritis with rheumatoid factor of hand without organ or systems involvement (rheumatoid, seropositive, without organ involvement, hand joint), M05.75 — Rheumatoid arthritis with rheumatoid factor of hip without organ or systems involvement (rheumatoid, seropositive, without organ involvement, hip), M05.76 — Rheumatoid arthritis with rheumatoid factor of knee without organ or systems involvement (rheumatoid, seropositive, without organ involvement, knee), M05.77 — Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or systems involvement (rheumatoid, seropositive, without organ involvement, ankle), M05.79 — Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement (rheumatoid, seropositive, without organ involvement, multiple sites), +153 more

Contextual Map

Every relationship of M00.11 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

• M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00-M25 — Arthropathies[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00-M02 — Infectious arthropathies[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Nearest codes (40)

• M00 — Pyogenic arthritis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00.04 — Staphylococcal arthritis, hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00.041 — Staphylococcal arthritis, right hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00.042 — Staphylococcal arthritis, left hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00.049 — Staphylococcal arthritis, unspecified hand[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00.05 — Staphylococcal arthritis, hip[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00.051 — Staphylococcal arthritis, right hip[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• M00.052 — Staphylococcal arthritis, left hip[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 32 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to M00.11 in its code family, with their registry titles.

• M00.079 — Staphylococcal arthritis, unspecified ankle and foot
• M00.08 — Staphylococcal arthritis, vertebrae
• M00.09 — Staphylococcal polyarthritis
• M00.1 — Pneumococcal arthritis and polyarthritis
• M00.10 — Pneumococcal arthritis, unspecified joint
• M00.111 — Pneumococcal arthritis, right shoulder
• M00.112 — Pneumococcal arthritis, left shoulder
• M00.119 — Pneumococcal arthritis, unspecified shoulder
• M00.12 — Pneumococcal arthritis, elbow
• M00.121 — Pneumococcal arthritis, right elbow

View all codes in the M00 family