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ICD-10 Coding for Tendinopathy(M75.8, M76.6)

Complete ICD-10-CM coding and documentation guide for Tendinopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

TendonitisTendinitisTendon degeneration

Related ICD-10 Code Ranges

Complete code families applicable to Tendinopathy

M65-M77Primary Range

Disorders of synovium and tendon

This range includes various tendon disorders, including tendinopathy, which is characterized by tendon degeneration and pain.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
M75.8Other shoulder lesionsUse when imaging shows shoulder lesions not classified elsewhere.
  • Partial thickness tear <50% width without retraction
M76.6Achilles tendinitisUse when clinical and imaging findings confirm Achilles tendinopathy.
  • Tendon thickness >7mm + >3 neovascular zones on power Doppler

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 rotator cuff tendinopathy

Essential facts and insights about Tendinopathy

The ICD-10 code for rotator cuff tendinopathy is M75.8, which includes other shoulder lesions confirmed by imaging.

Primary ICD-10-CM Codes for tendinopathy

Other shoulder lesions
Non-billable Code

Decision Criteria

clinical Criteria

  • Imaging shows partial thickness tear <50% width.

Applicable To

  • Rotator cuff tendinopathy

Excludes

Clinical Validation Requirements

  • Partial thickness tear <50% width without retraction

Code-Specific Risks

  • Risk of incorrect coding if not confirmed by imaging.

Coding Notes

  • Ensure imaging supports the diagnosis of tendinopathy.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Encounter for general adult medical examination without abnormal findings

Z00.00
Use for routine exams where tendinopathy is incidentally found.

Enthesopathy, unspecified

M77.9
Use for related enthesopathy findings.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Rotator cuff tear or rupture, not specified as traumatic

M75.1
Use M75.1 if there is a full-thickness tear confirmed by imaging.

Spontaneous rupture of other tendons

M66.8
Use M66.8 if there is a confirmed rupture.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Tendinopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M75.8.

Impact

Clinical: Misdiagnosis risk., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials.

Mitigation Strategy

Always include imaging results., Verify clinical correlation.

Impact

Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Use M75.8 with laterality for rotator cuff tendinopathy.

Impact

Lack of imaging can lead to audit flags.

Mitigation Strategy

Ensure all diagnoses are supported by 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 Tendinopathy, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Tendinopathy

Use these documentation templates to ensure complete and accurate documentation for Tendinopathy. These templates include all required elements for proper coding and billing.

Rotator cuff tendinopathy

Specialty: Orthopedics

Required Elements

  • Imaging findings
  • Clinical symptoms
  • Treatment plan

Example Documentation

Patient presents with right shoulder pain. MRI shows partial thickness tear of the supraspinatus tendon. Plan includes physical therapy and monitoring.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Shoulder pain, possible tendinitis.
Good Documentation Example
Right shoulder pain with MRI-confirmed partial thickness tear of supraspinatus tendon. Treatment includes PT.
Explanation
The good example includes specific imaging findings and a treatment plan.

Need help with ICD-10 coding for Tendinopathy? Ask your questions below.

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