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ICD-10 Coding for Scapular Pain(M25.511, G89.21, G89.22)

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Learn about ICD-10 coding for scapular pain, including M25.511 and M25.512 codes, documentation requirements, and clinical validation.

Also known as:
Shoulder Blade PainScapula Pain
Related ICD-10 Code Ranges

Complete code families applicable to Scapular Pain

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

CodeDescription
M25.511Pain in right shoulder
M25.512Pain in left shoulder
Primary ICD-10-CM Codes
Pain in right shoulder
M25.511Billable
Differential Codes

Alternative codes to consider when ruling out similar conditions

Pain in thoracic spineM54.6

Use when pain originates from the thoracic spine and radiates to the scapula.

Documentation & Coding Risks

Avoid these common issues when documenting Scapular Pain.

Documenting 'shoulder pain' without laterality

Impact

Clinical: Ambiguous diagnosis affecting treatment., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.

Mitigation

Always specify laterality in documentation.

Using M54.6 for pure scapular pain

Impact

Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.

Mitigation

Use M25.51- for scapular pain unless thoracic spine involvement is documented.

Laterality Documentation

Impact

Failure to document laterality can lead to audit flags.

Mitigation

Implement mandatory laterality fields in EHR templates.

Frequently Asked Questions

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with M25.511.