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ICD-10 Coding for Tear of Rotator Cuff(M75.11, M75.1, M75.12)

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Learn how to accurately code rotator cuff tears with ICD-10, including traumatic and non-traumatic classifications, documentation requirements, and billing considerations.

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

Complete code families applicable to Tear of Rotator Cuff

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
M75.11Incomplete 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
Incomplete rotator cuff tear or rupture not specified as traumatic
M75.11
Differential Codes

Alternative codes to consider when ruling out similar conditions

Complete rotator cuff tear or rupture of right shoulder, not specified as traumaticM75.12

Use when imaging confirms full-thickness tear.

Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumaticM75.11

Use when no trauma is documented.

Documentation & Coding Risks

Avoid these common issues when documenting Tear of Rotator Cuff.

Omitting laterality in documentation

Impact

Clinical: Leads to incomplete diagnosis, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials

Mitigation

Always specify right or left in notes, Double-check imaging reports 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 clinical data.

Mitigation

Verify the presence or absence of a traumatic event in documentation.

Trauma documentation

Impact

Lack of clear documentation of traumatic events can lead to audit issues.

Mitigation

Ensure all traumatic events are clearly documented in patient history.

Frequently Asked Questions

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with M75.11.