Shoulder Pain ICD-10-CM Codes

Explore a comprehensive guide to ICD-10 codes for shoulder pain, including clinical descriptions, billable status, and coding insights for practitioners.

By Wynona Jugueta on Aug 8, 2025.

Fact Checked by Karina Jimenea.

Use Code

What ICD-10 codes are used for shoulder pain?

Shoulder pain is a common musculoskeletal complaint, often stemming from joint disorders, overuse injuries, or inflammation of the rotator cuff tendons. It can present as localized pain, referred pain, or even bilateral pain depending on the root cause and severity. To ensure proper diagnosis, medical necessity, and accurate billing, healthcare providers use ICD-10 codes to classify these conditions based on the affected area and underlying pathology.

M25.511: Pain in right shoulder: This code signifies pain in the shoulder localized to the right shoulder area.
M25.512: Pain in left shoulder: Used to identify discomfort or severe pain in the left ball and socket joint of the upper arm bone and shoulder socket.
M25.519: Pain in unspecified shoulder: Applied when unspecified shoulder pain is documented without laterality.
M75.90: Shoulder lesion, unspecified, unspecified shoulder: Appropriate when the underlying cause is unknown or not well defined.
M75.00: Adhesive capsulitis of unspecified shoulder: Also called frozen shoulder, this condition leads to chronic pain and stiffness that can hinder physical activities.

Which Shoulder Pain ICD codes are Billable?

M25.511: Yes
M25.512: Yes
M25.519: Yes
M75.90: Yes
M75.00: Yes

Clinical Information

Pain in the shoulder can be acute or chronic pain, often resulting from a rotator cuff tear, rheumatoid arthritis, trauma, or joint pain related to joint disorders. Common causes include overuse injuries, repetitive strain, or degeneration in the shoulder socket or soft tissue structures.
Evaluation typically starts with a thorough physical examination and may be followed by diagnostic imaging such as X-rays, magnetic resonance imaging (MRI), or ultrasound to assess shoulder problems involving the joint, tendons, or shoulder blade.
Treatment varies depending on the underlying issue and may involve rest, anti-inflammatory medications, guided exercises from a physical therapist, or surgical intervention in more severe cases. Addressing shoulder pain promptly ensures better recovery outcomes and minimizes disruptions in physical activities.

Synonyms include:

Pain in shoulder joint
Shoulder ache
Shoulder discomfort
Rotator cuff pain
Upper arm pain

Commonly asked questions

Use a shoulder pain ICD code when a patient presents with localized pain, joint pain, or discomfort in the shoulder area, including the ball-and-socket joint or rotator cuff tendons. These codes are appropriate for documenting symptoms for clinical evaluation, treatment, and insurance billing purposes.

Common treatments include rest, physical therapy with a physical therapist, anti-inflammatory medications, or corticosteroid injections. Severe or chronic cases involving rotator cuff tendinitis, joint disorders, or soft tissue damage may require magnetic resonance imaging and surgical intervention.

A shoulder pain diagnosis code indicates that the patient is experiencing pain in the shoulder, either acute or chronic pain, with or without a clearly identified cause. It helps classify the shoulder problem for accurate treatment planning and supports the documentation of medical necessity.

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