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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M19.212

Billable / Specific

Secondary osteoarthritis, left shoulder

M19
Block
0
Synonyms
348
LCDs
8
Payer Policies
1
Linked CPTs

About ICD-10-CM M19.212

ICD-10-CM code M19.212 represents Secondary osteoarthritis, left shoulder. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M19). The 2026 edition of ICD-10-CM M19.212 became effective on October 1, 2025.

Medicare LCD Coverage for M19.212

Local Coverage Determinations (LCDs) from CMS MACs that list M19.212 as a covered diagnosis.

348 LCDs

Showing top 10 of 348 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29131 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29260 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29580 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97036 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29445 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97542 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29130 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29405 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M19.212.

8 policies

1 Cigna

Peripheral Nerve Destruction for Pain Conditions - (0525) ---- future effective policy
Policy ID: MM_0525

5 Medicare

Billing and Coding: Hyaluronans Intra-articular Injections of
Policy ID: ART-52420
Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065

CPT Codes Commonly Billed with M19.212

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

1 linkages
  • 23472 CMS LCD: Billing and Coding: Total Shoulder Arthroplasty CMS LCD

Convert M19.212 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M19.212 71521 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To M19.212

Other codes in section M15-M19 (Osteoarthritis).

M15 Polyosteoarthritis (non-billable) M15.0 Primary generalized (osteo)arthritis M15.1 Heberden's nodes (with arthropathy) M15.2 Bouchard's nodes (with arthropathy) M15.3 Secondary multiple arthritis M15.4 Erosive (osteo)arthritis M15.8 Other polyosteoarthritis M15.9 Polyosteoarthritis, unspecified M16 Osteoarthritis of hip (non-billable) M16.0 Bilateral primary osteoarthritis of hip M16.1 Unilateral primary osteoarthritis of hip (non-billable) M16.10 Unilateral primary osteoarthritis, unspecified hip M16.11 Unilateral primary osteoarthritis, right hip M16.12 Unilateral primary osteoarthritis, left hip M16.2 Bilateral osteoarthritis resulting from hip dysplasia M16.3 Unilateral osteoarthritis resulting from hip dysplasia (non-billable) M16.30 Unilateral osteoarthritis resulting from hip dysplasia, unspecified hip M16.31 Unilateral osteoarthritis resulting from hip dysplasia, right hip M16.32 Unilateral osteoarthritis resulting from hip dysplasia, left hip M16.4 Bilateral post-traumatic osteoarthritis of hip

ICD-10 M19.212, Billing FAQ

Is ICD-10 code M19.212 billable? +

Yes, M19.212 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with M19.212? +

Procedures frequently paired with M19.212 include: 23472.

What ICD-9 codes does M19.212 map to? +

Per CMS GEMs, M19.212 maps to ICD-9 codes: 71521. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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