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Home/Diagnosis/ICD-10 Coding for Right Shoulder Conditions

ICD-10 Coding for Right Shoulder Conditions

M25.511
M75.111
S46.011A

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

Also Known as:
Right Shoulder Pain
Right Rotator Cuff Injury
Right Shoulder Impingement
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Key Information: ICD-10 Coding for Right Shoulder Conditions

Essential facts and insights about ICD-10 Coding for Right Shoulder Conditions

Use ICD-10 code M25.511 for pain in right shoulder, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Pain in right shoulder

Billable Code
M25.511
Billable

Diagnostic Criteria

  • • Pain persists >6 weeks
  • • Negative MRI/X-ray
  • • Excluded referred pain (e.g., cervical)

Applicable To

  • • Isolated right shoulder pain

Important Notes

  • • Ensure documentation specifies right shoulder and excludes other causes.

Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic

Billable Code
M75.111
Billable

Diagnostic Criteria

  • • Positive Hawkins-Kennedy test
  • • Weakness on empty can test
  • • MRI showing ≥50% thickness tear

Applicable To

  • • Rotator cuff-related pain

Important Notes

  • • Document specific tests and imaging findings.

Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter

Billable Code
S46.011A
Billable

Diagnostic Criteria

  • • Mechanism of injury (e.g., fall on outstretched arm)
  • • MRI-confirmed full-thickness tear

Applicable To

  • • Acute traumatic rotator cuff injury

Important Notes

  • • Ensure documentation includes the mechanism of injury.
Ancillary Codes

Additional codes that may be used with this diagnosis

W19.XXXA

Unspecified fall, initial encounter

Use to specify the cause of injury.

Frequently Asked Questions

How to code right shoulder pain with normal imaging?

Use ICD-10 code M25.511 for right shoulder pain when imaging is normal and no specific underlying condition is identified.

What is the ICD-10 code for right rotator cuff tear?

The ICD-10 code for a non-traumatic right rotator cuff tear is M75.111.

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