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Home/Diagnosis/ICD-10 Coding for Rotator Cuff Tear

ICD-10 Coding for Rotator Cuff Tear

S46.011A
M75.121

Complete ICD-10-CM coding and documentation guide for icd-10 coding for rotator cuff tear includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Shoulder Tendon Tear
Supraspinatus Tear
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Key Information: ICD-10 Coding for Rotator Cuff Tear

Essential facts and insights about ICD-10 Coding for Rotator Cuff Tear

Use ICD-10 code S46.011A for strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

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

Billable Code
S46.011A
Billable

Diagnostic Criteria

  • • Documented traumatic event leading to tear

Applicable To

  • • Acute traumatic full-thickness tear of right shoulder

Important Notes

  • • Ensure documentation specifies the traumatic nature and laterality.

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

Billable Code
M75.121
Billable

Applicable To

  • • Chronic degenerative full-thickness tear of right shoulder

Important Notes

  • • Ensure documentation specifies degenerative nature and laterality.
Ancillary Codes

Additional codes that may be used with this diagnosis

M75.81

Other shoulder lesions

Use when bursitis is present with the tear.

M75.3

Rotator cuff tendinitis

Use if inflammation is documented with the tear.

Frequently Asked Questions

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

The ICD-10 code for a traumatic rotator cuff tear is S46.01-, while M75.1- is used for non-traumatic tears.

How do you differentiate between acute and chronic rotator cuff tears in coding?

Acute tears are coded as traumatic (S46.01-) if linked to an injury, while chronic tears are degenerative (M75.1-) with no trauma history.

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