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ICD-10 Coding for Rotator Cuff Rupture(S46.011A, M75.121, M75.1)

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Learn about the ICD-10 coding for rotator cuff ruptures, including traumatic and non-traumatic tears, with documentation requirements and coding tips.

Also known as:
Rotator Cuff TearShoulder Tendon Tear
Related ICD-10 Code Ranges

Complete code families applicable to Rotator Cuff Rupture

S00-T88Primary Range

Injury, poisoning and certain other consequences of external causes

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescription
S46.011AStrain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter
M75.121Non-traumatic complete tear of rotator cuff of right shoulder
Primary ICD-10-CM Codes
Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter
S46.011ABillable
Differential Codes

Alternative codes to consider when ruling out similar conditions

Non-traumatic complete tear of rotator cuff of right shoulderM75.121
Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounterS46.011A

Documentation & Coding Risks

Avoid these common issues when documenting Rotator Cuff Rupture.

Omitting laterality in documentation

Impact

Clinical: Leads to incomplete patient records., Regulatory: May result in coding errors and audits., Financial: Can cause claim denials or delays.

Mitigation

Always document which shoulder is affected., Use templates that prompt for laterality.

Confusing traumatic and non-traumatic codes

Impact

Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification may result in compliance issues., Data Quality: Affects the accuracy of patient records.

Mitigation

Verify the presence of trauma in the patient's history before coding.

Trauma documentation

Impact

Inadequate documentation of trauma can lead to incorrect coding.

Mitigation

Ensure all trauma-related cases have detailed injury descriptions.

Frequently Asked Questions

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with S46.011A.