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

ICD-10 Coding for Tear of Rotator Cuff

M75.11
S46.011A

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

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

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

Use ICD-10 code M75.11 for incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

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

Non-Billable
M75.11
Non-Billable

Diagnostic Criteria

clinical:
  • • Partial tear confirmed by imaging
documentation:
  • • Absence of trauma history

Applicable To

  • • Partial tear of rotator cuff

Important Notes

  • • Ensure laterality is documented.

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

Billable Code
S46.011A
Billable

Diagnostic Criteria

clinical:
  • • Documented mechanism of injury
  • • Acute onset of symptoms

Applicable To

  • • Traumatic tear of rotator cuff

Important Notes

  • • Ensure the traumatic event is clearly documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

M75.3

Calcific tendinitis of shoulder

Use if calcific deposits are present in the tendon.

W19.XXXA

Unspecified fall, initial encounter

Use to specify the external cause of injury.

Frequently Asked Questions

How do you code a rotator cuff tear?

Code a rotator cuff tear using M75.1- for non-traumatic tears and S46.01- for traumatic tears, ensuring documentation specifies laterality and tear type.

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

The ICD-10 code for a traumatic rotator cuff tear is S46.01-, with additional codes for external causes if applicable.

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