ICD-10 Coding for Right Shoulder Tendinitis(M75.51, M75.31, M67.813)
Complete ICD-10-CM coding and documentation guide for Right Shoulder Tendinitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Shoulder Tendinitis
M75.3-M75.5Primary Range
Disorders of bursae and tendons in shoulder region
This range includes specific codes for tendinitis of the shoulder, including calcific and bicipital tendinitis.
Other specified disorders of synovium and tendon
Used for unspecified tendon disorders when specific tendinitis codes are not applicable.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M75.51 | Bicipital tendinitis, right shoulder | Use when there is documented inflammation of the biceps tendon with clinical confirmation. |
|
| M75.31 | Calcific tendinitis, right shoulder | Use when imaging confirms calcific deposits in shoulder tendons. |
|
| M67.813 | Other specified disorders of tendon, right shoulder | Use when tendinitis is documented but not specified as bicipital or calcific. |
|
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 right shoulder tendinitis
Essential facts and insights about Right Shoulder Tendinitis
Primary ICD-10-CM Codes for right shoulder tendinitis
Decision Criteria
clinical Criteria
- Presence of bicipital groove tenderness and positive Speed's test.
Applicable To
- Inflammation of the biceps tendon
Excludes
- Calcific tendinitis (M75.31)
Clinical Validation Requirements
- Positive Speed/Yergason tests
- Ultrasound showing biceps tendon thickening
Code-Specific Risks
- Misclassification if documentation lacks specificity of tendon involved.
Coding Notes
- Ensure documentation specifies 'bicipital' to avoid misclassification.
M75.31 - Calcific tendinitis, right shoulder
Use when imaging confirms calcific deposits in shoulder tendons.
Applicable To
- Calcium deposits in shoulder tendons
Excludes
- Bicipital tendinitis (M75.51)
Clinical Validation Requirements
- Radiographic confirmation of calcifications
- Tenderness on direct probe during ultrasound
Coding Notes
Document calcification evidence clearly to support this code.
M67.813 - Other specified disorders of tendon, right shoulder
Use when tendinitis is documented but not specified as bicipital or calcific.
Applicable To
- Unspecified tendinitis of the shoulder
Excludes
- Specific tendinitis codes like M75.51 and M75.31
Clinical Validation Requirements
- MRI/ultrasound showing tendinosis
- Pain with resisted abduction
Coding Notes
Use only when documentation lacks specificity for other primary codes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pain in right shoulder
M25.511Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Shoulder Tendinitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M75.51.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Increased risk of audit issues., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Ensure detailed clinical documentation, Use imaging to confirm specific tendinitis type
Impact
Reimbursement: Potential underpayment due to non-specific coding., Compliance: Risk of audit failure for lack of specificity., Data Quality: Decreased accuracy in clinical data reporting.
Mitigation Strategy
Append specific tendinitis code first
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Specify calcium deposits in documentation
Impact
Audits may target lack of specificity in tendon documentation.
Mitigation Strategy
Ensure clinical notes specify the tendon involved and confirm with imaging.
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 Right Shoulder Tendinitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Shoulder Tendinitis
Use these documentation templates to ensure complete and accurate documentation for Right Shoulder Tendinitis. These templates include all required elements for proper coding and billing.
Orthopedic Progress Note
Specialty: OrthopedicsRequired Elements
- Subjective complaints
- Objective findings
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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