Right Shoulder Pain ICD-10-CM Codes

What ICD-10 codes are used for right shoulder pain?

Accurate documentation of right shoulder pain is crucial for effective treatment planning, insurance reimbursement, and patient care. The International Classification of Diseases (ICD-10-CM) provides specific codes to denote various shoulder conditions. Below are the commonly used ICD-10-CM codes related to right shoulder pain:

M25.511 – Pain in right shoulder

This code is used when a patient presents with pain in the right shoulder without a specific underlying diagnosis. It encompasses general shoulder joint pain and is applicable in cases where the pain is not attributed to a defined condition like rotator cuff tendinitis or frozen shoulder.

M75.101 – Unspecified rotator cuff tear or rupture, not specified as traumatic

Applied when imaging or clinical evaluation confirms a rotator cuff tear in the right shoulder, but the specifics regarding the cause (traumatic or non-traumatic) are not detailed

M75.111 – Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic

Denotes a partial tear of the rotator cuff muscles in the right shoulder, where the cause is not specified as traumatic.

M75.121 – Complete rotator cuff tear or rupture of right shoulder, not specified as traumatic

Indicates a full-thickness tear of the rotator cuff tendons in the right shoulder, with no specified cause.

M75.51 – Bursitis of the shoulder

Used when a patient is diagnosed with shoulder bursitis, an inflammation of the bursa in the shoulder joint, leading to pain and restricted movement.

M19.011 – Primary osteoarthritis, right shoulder

Applied in cases where degenerative changes in the right shoulder joint lead to chronic pain and reduced mobility.

S43.401A – Sprain of unspecified parts of right shoulder girdle, initial encounter

This code is used for an initial encounter when a patient presents with a shoulder sprain in the right shoulder girdle, and the specific part is not detailed.

Which right shoulder pain ICD codes are billable?

All the codes listed above are billable under the ICD-10-CM system. They are used to accurately bill and document a patient's condition, support insurance reimbursement, and guide appropriate treatment options.

Clinical information

Right shoulder pain can result from various conditions affecting the musculoskeletal system, including rotator cuff injuries, adhesive capsulitis (frozen shoulder), shoulder impingement syndrome, and acromioclavicular joint disorders. Patients may experience pain during movement, motion pain, limited range of motion, and discomfort during daily activities.

Accurate diagnosis often involves a thorough physical exam, imaging tests, and patient medical history assessment. Treatment often includes interventions provided by healthcare professionals like physical therapists, such as range-of-motion exercises, strengthening routines, and posture correction, to relieve pain and restore function.

Treatment strategies may also include physical therapy, ice therapy, corticosteroid injections, and, in severe cases, surgical options. Implementing range of motion exercises, strengthening exercises, and ergonomic adjustments can aid in recovery and prevent further injury.

Synonyms include

• Pain in the right shoulder
• Right shoulder joint pain
• Right acromioclavicular joint pain
• Right shoulder bursitis
• Right shoulder impingement
• Right shoulder tendinitis
• Right shoulder sprain
• Right shoulder rotator cuff tear

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