M02.811 — Other reactive arthropathies, right shoulder
Is M02.811 billable?
Yes — M02.811 is billable for FY2027. M02.811 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M02.811 may be submitted for encounters from October 1, 2026 through September 30, 2027.
M02.811 at a glance
| Code | M02.811 |
|---|---|
| Description | Other reactive arthropathies, right shoulder |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to M02.811?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M02.811 directly.
This code describes a manifestation of an underlying disease. The underlying condition must be sequenced before it, so it can never be the principal or first-listed diagnosis.
Which MS-DRGs does M02.811 group to?
M02.811 sits in MDC 08 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 548Septic Arthritis with MCCmedical
- 549Septic Arthritis with CCmedical
- 550Septic Arthritis without CC/MCCmedical
As a secondary diagnosis, M02.811 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is M02.811 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under M02.81, the nearest indexed parent of M02.811. Use them to find the family, then select the specific code.
- Arthropathy › reactive › specified type NEC › shoulder
Excludes1 — never code together — inherited from M02
The conditions below can never be reported together with M02.811 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first — inherited from M02
The underlying condition below must be sequenced before M02.811. M02.811 describes a manifestation and cannot be the principal or first-listed diagnosis.
Excludes2 — not included here — inherited from Chapter 13
The conditions below are not part of M02.811, but a patient may have both at the same time. When documentation supports it, M02.811 and the excluded code may both 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)
How long has M02.811 existed?
M02.811 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.