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ICD-10 Coding for Supraspinatus Tear(M75.121, M25.511, M75.1)

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Comprehensive guide on ICD-10 coding for supraspinatus tears, including documentation requirements, common pitfalls, and clinical validation.

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

Complete code families applicable to Supraspinatus Tear

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
M75.121Complete rotator cuff tear or rupture of right shoulder, not specified as traumatic
S46.011AStrain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter
Primary ICD-10-CM Codes
Complete rotator cuff tear or rupture of right shoulder, not specified as traumatic
M75.121Billable
Differential Codes

Alternative codes to consider when ruling out similar conditions

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

Use when imaging shows partial-thickness tear.

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

Use when tear is atraumatic.

Documentation & Coding Risks

Avoid these common issues when documenting Supraspinatus Tear.

Failing to document the traumatic event for S46.011A

Impact

Clinical: Inaccurate representation of injury cause, Regulatory: Non-compliance with coding standards, Financial: Potential denial of claims

Mitigation

Always document the mechanism of injury, Include patient statements about the event

Using M75.10 for unspecified tear when imaging confirms thickness

Impact

Reimbursement: Potential underpayment due to lack of specificity, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in clinical data

Mitigation

Specify the tear as partial or complete based on imaging.

Inaccurate coding of tear type

Impact

Risk of audits due to incorrect specification of tear as partial or complete

Mitigation

Ensure thorough documentation and imaging confirmation.

Frequently Asked Questions

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with M75.121.