M11.19

Familial chondrocalcinosis affecting multiple joint sites simultaneously, caused by an inherited predisposition to calcium pyrophosphate dihydrate (CPPD) crystal deposition in articular cartilage.

Verified May 8, 2026 · 4 sources ↓

Status: Billable
Chapter: 13
Related CPT: 13
Region: Multi-region

Drawn from CDCICD10DataAAPCCMS

Documentation tips

What should appear in the chart to support M11.19.

Source · Editorial brief grounded in 4 cited references ↓

Provider must explicitly document the hereditary or familial basis of the chondrocalcinosis — 'family history of CPPD' or 'familial chondrocalcinosis' in the assessment; without this, use M11.2x (Other chondrocalcinosis) instead.
List each affected joint by name in the assessment or problem list to support the 'multiple sites' descriptor; a vague note like 'polyarticular CPPD' without joint enumeration weakens coding specificity.
Document imaging findings at each affected site — radiographic chondrocalcinosis (linear calcification in articular cartilage, triangular fibrocartilage, menisci) per joint — to substantiate multi-site involvement.
If crystal analysis was performed (joint aspiration showing CPP crystals on compensated polarized microscopy), include the result and the joint from which fluid was obtained.
Record any prior workup for secondary causes of CPPD (hyperparathyroidism, hemochromatosis, hypomagnesemia) to confirm the familial rather than metabolic etiology.

Related CPT procedures

Procedure codes commonly billed with M11.19. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

20600 $56.11

Needle aspiration and/or injection of a small joint or bursa — such as a finger or toe joint — performed without ultrasound guidance.

20604 $87.18

Arthrocentesis, aspiration and/or injection of a small joint or bursa (e.g., fingers, toes) performed with ultrasound guidance, including permanent image recording and reporting.

20605 $57.12

Aspiration and/or injection of an intermediate joint or bursa — such as the wrist, elbow, ankle, acromioclavicular joint, or olecranon bursa — performed without ultrasound guidance.

20606 $94.19

Aspiration and/or injection of an intermediate joint or bursa — such as the wrist, elbow, ankle, acromioclavicular, temporomandibular, or olecranon bursa — performed with real-time ultrasound guidance and permanent image recording and reporting.

20610 $68.81

Aspiration and/or injection of a major joint or bursa (shoulder, hip, knee, or subacromial bursa) performed without ultrasound guidance.

20611 $104.21

Aspiration or injection of a major joint or bursa performed under real-time ultrasound guidance, with permanent image documentation.

73560 $34.40

Radiologic examination of the knee joint, one or two views, unilateral.

73562 $42.42

Three-view radiographic examination of the knee joint, capturing anteroposterior, lateral, and a third angle such as a sunrise or oblique view.

73564 $49.43

Radiologic examination of the knee consisting of four or more views, including oblique and tunnel projections, for a complete diagnostic workup.

73580 $117.24

Radiologic examination of the knee joint using arthrography — contrast injection and radiological supervision and interpretation only.

73700 $130.26

CT scan of the lower extremity performed without contrast material, producing cross-sectional images of bones, soft tissue, and other structures without injected dye.

73721 $204.41

MRI of a lower extremity joint (hip, knee, or ankle) performed without contrast material.

77080 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M11.19 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Using M11.19 for sporadic or idiopathic multi-site CPPD disease — without documented familial etiology, the correct code is M11.29 (Other chondrocalcinosis, multiple sites), not M11.19.
Defaulting to M11.19 when only one joint is clinically involved — if a single site is documented, use the appropriate single-site M11.1x code to preserve maximum specificity.
Confusing chondrocalcinosis with gout: gout (M1A/M10 category) involves monosodium urate crystals; CPPD/chondrocalcinosis involves calcium pyrophosphate crystals — do not interchange these code families.
Coding M11.19 without corroborating imaging or crystal analysis documentation, which exposes the claim to medical necessity audit without supporting clinical evidence in the chart.
Failing to code underlying metabolic conditions separately when they coexist — if a metabolic disorder is also present and contributing, code it additionally; however, for the strictly familial form, a secondary etiology code is generally not appropriate.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

M11.19 applies when the provider documents familial (hereditary) chondrocalcinosis involving more than one joint site and the specific pattern of involvement is not captured by a single-site sibling code under M11.1x. The familial designation requires a documented or clinically implied hereditary basis — sporadic CPPD disease belongs under M11.2x (Other chondrocalcinosis), not M11.1x. If you're coding a patient with chondrocalcinosis in, say, bilateral knees and wrists with a confirmed family history, M11.19 is the correct landing code over any single-site or unspecified alternative.

Within the M11.1 family, site-specific codes exist for shoulder (M11.11x), elbow (M11.12x), wrist (M11.13x), hand (M11.14x), hip (M11.15x), knee (M11.16x), ankle/foot (M11.17x), and other single sites (M11.18x). Reserve M11.19 for encounters where the clinical record explicitly documents polyarticular involvement under a familial etiology. Do not default to M11.19 simply because multiple joints hurt — each affected joint must be documented, and the multi-site descriptor must be clinically supported.

Chondrocalcinosis is a joint disease, not a bone disease. Imaging (plain radiograph or CT) showing calcification of articular cartilage at multiple joints — combined with provider documentation of hereditary etiology or positive family history — anchors this code. Crystal analysis from joint fluid (CPP crystals on compensated polarized microscopy) can further confirm the diagnosis but is not required for coding if clinical documentation is sufficient.

Sibling codes

Other billable codes under M11.1 (laterality / anatomic variants).

M11.18

Familial chondrocalcinosis, vertebrae

M11.10

Familial chondrocalcinosis, unspecified site

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01What distinguishes M11.19 from M11.29?

M11.19 is familial (hereditary) chondrocalcinosis at multiple sites; M11.29 is 'other' (sporadic or idiopathic) chondrocalcinosis at multiple sites. The etiology documented by the provider — familial vs. not — drives the selection. If the provider hasn't specified a hereditary basis, use M11.29.

02How many joints must be involved to use the 'multiple sites' code?

ICD-10-CM does not define a numeric threshold, but 'multiple sites' means more than one anatomically distinct joint is documented as involved. Two or more separately named joints — e.g., bilateral knees and right wrist — satisfy the descriptor. If only one joint is documented, use the specific single-site M11.1x code.

03Can M11.19 be used without imaging confirmation?

The code itself does not require imaging for assignment, but payer medical necessity review often expects radiographic or crystal-analysis evidence. Document whatever diagnostic support exists — radiograph, CT, ultrasound, or synovial fluid CPP crystal analysis — to defend the claim.

04Is a family history notation sufficient to establish 'familial' etiology for M11.19?

A documented family history of chondrocalcinosis or CPPD disease in the provider's note supports the familial designation. Genetic testing is not required for ICD-10-CM coding purposes, but the provider must make the clinical determination and state it in the record.

05Should secondary metabolic causes be coded separately alongside M11.19?

For the strictly familial form (M11.19), a secondary metabolic etiology code is generally not applicable because the hereditary mechanism is primary. If the provider documents both a familial pattern and a coexisting metabolic condition, code both and sequence based on the reason for the encounter.

06What CPT procedures are commonly linked to encounters coded M11.19?

Joint aspiration and injection codes (20600–20611) are common when acute pseudogout flares are treated. Radiographs (73560–73564 for knee, 73700 for CT) document calcification. MRI (73721) may be ordered for soft-tissue detail. Bone density (77080) is sometimes ordered given overlapping metabolic workup in this population.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

01CDC ICD-10-CM Tabular List 2026 (effective Oct 1, 2025)
02
icd10data.com
https://www.icd10data.com/ICD10CM/Codes/M00-M99/M05-M14/M11-/M11.19
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M11.19
04
cms.gov
https://www.cms.gov/Medicare/Coding/ICD10/Downloads/2019-ICD10-Coding-Guidelines-.pdf

Mira AI Scribe

Mira AI Scribe captures the affected joint list, family history of CPPD or chondrocalcinosis, radiographic findings at each site (cartilage calcification, meniscal or TFCC involvement), and any crystal analysis results from joint aspiration. Capturing these elements prevents downcoding to an unspecified or single-site code and avoids substitution of the sporadic M11.29 code when the familial etiology is clinically established.

See how Mira captures M11.19 documentation