ICD-10 Coding for Impingement Syndrome(M75.41, M75.42)
Complete ICD-10-CM coding and documentation guide for Impingement Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Impingement Syndrome
M75.4Primary Range
Impingement syndrome of shoulder
This range covers all forms of shoulder impingement, specifying laterality.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M75.41 | Impingement syndrome of right shoulder | Use when clinical tests confirm impingement in the right shoulder. |
|
| M75.42 | Impingement syndrome of left shoulder | Use when clinical tests confirm impingement in the left shoulder. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for shoulder impingement
Essential facts and insights about Impingement Syndrome
Primary ICD-10-CM Codes for impingement syndrome
Decision Criteria
clinical Criteria
- Presence of positive impingement tests
documentation Criteria
- MRI evidence of subacromial narrowing
Applicable To
- Right shoulder impingement
Excludes
- General shoulder pain (M25.511)
Clinical Validation Requirements
- Positive Hawkins or Neer sign
- MRI showing subacromial narrowing
Code-Specific Risks
- Confusion with general shoulder pain codes
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
M75.42 - Impingement syndrome of left shoulder
Use when clinical tests confirm impingement in the left shoulder.
Applicable To
- Left shoulder impingement
Excludes
- General shoulder pain (M25.512)
Clinical Validation Requirements
- Positive Hawkins or Neer sign
- MRI showing subacromial narrowing
Coding Notes
Ensure laterality is documented to avoid unspecified codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Bursitis of shoulder
M75.51Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Impingement Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M75.41.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Include results of Hawkins and Neer tests in notes, Ensure imaging findings are documented
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Always document and code the specific shoulder affected.
Impact
Using unspecified codes can trigger audits.
Mitigation Strategy
Ensure complete documentation of laterality and clinical findings.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Impingement Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Impingement Syndrome
Use these documentation templates to ensure complete and accurate documentation for Impingement Syndrome. These templates include all required elements for proper coding and billing.
Post-operative follow-up for shoulder impingement surgery
Specialty: OrthopedicsRequired Elements
- Patient-reported outcomes
- Range of motion measurements
- Strength testing results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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