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Home/Diagnosis/ICD-10 Coding for Reverse Total Shoulder Arthroplasty

ICD-10 Coding for Reverse Total Shoulder Arthroplasty

M12.511

Complete ICD-10-CM coding and documentation guide for icd-10 coding for reverse total shoulder arthroplasty includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Reverse Shoulder Replacement
Reverse TSA
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Key Information: ICD-10 Coding for Reverse Total Shoulder Arthroplasty

Essential facts and insights about ICD-10 Coding for Reverse Total Shoulder Arthroplasty

Use ICD-10 code M12.511 for arthropathy, shoulder, with rotator cuff tear, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Arthropathy, shoulder, with rotator cuff tear

Billable Code
M12.511
Billable

Diagnostic Criteria

clinical_criteria:
  • • Presence of rotator cuff tear confirmed by imaging

Applicable To

  • • Rotator cuff tear arthropathy

Important Notes

  • • Ensure documentation specifies rotator cuff involvement.
Ancillary Codes

Additional codes that may be used with this diagnosis

Z47.89

Aftercare following joint replacement

Use for follow-up care post-surgery.

Frequently Asked Questions

What is the ICD-10 code for reverse total shoulder arthroplasty?

The ICD-10 code for reverse total shoulder arthroplasty primarily involves M12.511 for arthropathy with rotator cuff tear, often used with procedure code 23472.

When should modifier 22 be used with reverse TSA?

Modifier 22 is used with reverse TSA when the procedure requires significantly more time or complexity, such as in cases with severe scar tissue.

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