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

ICD-10 Coding for Traumatic Rotator Cuff Tear

S46.011A
S46.012A

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

Also Known as:
Acute Rotator Cuff Tear
Traumatic Shoulder Tear
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Key Information: ICD-10 Coding for Traumatic Rotator Cuff Tear

Essential facts and insights about ICD-10 Coding for Traumatic 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

clinical:
  • • Presence of acute trauma leading to shoulder pain and weakness.
documentation:
  • • MRI or ultrasound confirmation of tear.

Applicable To

  • • Acute traumatic tear of right supraspinatus
  • • Acute traumatic tear of right infraspinatus

Important Notes

  • • Ensure documentation clearly states the traumatic nature and specifies the tendon involved.

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

Billable Code
S46.012A
Billable

Applicable To

  • • Acute traumatic tear of left supraspinatus
  • • Acute traumatic tear of left infraspinatus

Important Notes

  • • Ensure documentation clearly states the traumatic nature and specifies the tendon involved.
Ancillary Codes

Additional codes that may be used with this diagnosis

W19.XXXA

Fall from same level, initial encounter

Use to specify the external cause of the traumatic event.

Frequently Asked Questions

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 specific codes for laterality such as S46.011A for the right shoulder.

How do you document a traumatic rotator cuff tear?

Document the traumatic event, specify the tendon involved, confirm with imaging, and note laterality to ensure accurate coding.

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