What is the ICD-10 code for rotator cuff syndrome?

The ICD-10 code for rotator cuff syndrome varies based on the condition's specifics, such as M75.111 for non-traumatic partial tears and S46.011A for traumatic tears.

How do you code a traumatic rotator cuff tear?

For a traumatic rotator cuff tear, use S46.011A for the right shoulder, ensuring documentation includes the traumatic event.

ICD-10 Coding for Rotator Cuff Syndrome(M75.111, M75.1, M75.121)

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Explore detailed ICD-10 coding guidelines for rotator cuff syndrome, including traumatic and non-traumatic tears, with documentation requirements.

Also known as:

Rotator Cuff TearShoulder Impingement Syndrome

Related ICD-10 Code Ranges

Complete code families applicable to Rotator Cuff Syndrome

M00-M99Primary Range

Diseases of the musculoskeletal system and connective tissue

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Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

Code	Description	When to Use	Key Documentation
M75.111	Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic	Use for non-traumatic partial tears of the right shoulder.	MRI showing partial-thickness tear Positive Neer or Hawkins test
S46.011A	Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter	Use for acute traumatic tears of the right shoulder.	History of trauma MRI showing acute tear

Primary ICD-10-CM Codes

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

M75.111Billable

Differential Codes

Alternative codes to consider when ruling out similar conditions

Complete rotator cuff tear or rupture of right shoulder, not specified as traumaticM75.121

Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumaticM75.111

Documentation & Coding Risks

Avoid these common issues when documenting Rotator Cuff Syndrome.

Failing to document the traumatic event

Impact

Clinical: Leads to incorrect diagnosis coding., Regulatory: May result in audit issues., Financial: Can cause claim denials.

Mitigation

Always ask about recent trauma during patient history., Document any reported incidents clearly.

Confusing traumatic and degenerative tears

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.

Trauma documentation

Impact

Lack of documentation for traumatic events leading to rotator cuff tears.

Mitigation

Implement a checklist for trauma history in patient evaluations.

Frequently Asked Questions

Documentation requirements, coding pitfalls and FAQs for conditions coded with M75.111.

Primary Code

M75.111

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

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ICD-10 codes7

Coding risks3

FAQs2

ICD-10 Coding for Rotator Cuff Syndrome(M75.111, M75.1, M75.121)

Documentation & Coding Risks

Frequently Asked Questions

What is the ICD-10 code for rotator cuff syndrome?

How do you code a traumatic rotator cuff tear?

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