ICD-10 Coding for Left Shoulder SLAP Tear(S43.432A)
Complete ICD-10-CM coding and documentation guide for Left Shoulder SLAP Tear. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Shoulder SLAP Tear
S43.4Primary Range
Sprain and strain of shoulder joint
This range includes codes for specific shoulder joint injuries, including SLAP lesions.
Key Information: ICD-10 code for left shoulder SLAP tear
Essential facts and insights about Left Shoulder SLAP Tear
Primary ICD-10-CM Code for left shoulder slap tear
Decision Criteria
clinical Criteria
- MRI shows high signal intensity in superior labrum.
documentation Criteria
- Detailed note on clinical tests and imaging results.
Applicable To
- Type I-IV SLAP tears
Excludes
- Bankart lesion (S43.431A)
Clinical Validation Requirements
- MRI confirmation of superior labral tear
- Positive O'Brien's test
Code-Specific Risks
- Incorrect use without MRI confirmation
- Misuse with Bankart lesions
Coding Notes
- Ensure documentation specifies laterality and confirms SLAP tear type.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Bicipital tendinitis, left shoulder
M75.21Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Superior glenoid labrum lesion of right shoulder, initial encounter
S43.431ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Shoulder SLAP Tear to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S43.432A.
Impact
Clinical: Ambiguity in treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify left or right shoulder in documentation., Review notes for completeness before submission.
Impact
Reimbursement: Claims may be denied due to lack of supporting documentation., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data and statistics.
Mitigation Strategy
Ensure MRI findings support the diagnosis of a SLAP tear.
Impact
Incorrect use of modifiers 59 and 22 with SLAP repair codes.
Mitigation Strategy
Educate coding staff on proper modifier use and documentation requirements.
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 Left Shoulder SLAP Tear, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Shoulder SLAP Tear
Use these documentation templates to ensure complete and accurate documentation for Left Shoulder SLAP Tear. These templates include all required elements for proper coding and billing.
Initial evaluation of suspected SLAP tear
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Clinical tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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