ICD-10 Coding for Labral Tear of the Right Shoulder(M25.511, M25.511U, S43.421A)
Explore the ICD-10 coding for right shoulder labral tears, including documentation requirements, common pitfalls, and billing considerations.
Complete code families applicable to Labral Tear of the Right Shoulder
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S43.431A | Superior glenoid labrum lesion, right shoulder, initial encounter | Use for initial treatment of an acute labral tear in the right shoulder. |
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| S43.431D | Superior glenoid labrum lesion, right shoulder, subsequent encounter | Use for follow-up visits after initial treatment of a labral tear. |
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| S43.431S | Superior glenoid labrum lesion, right shoulder, sequela | Use for chronic conditions resulting from a previous labral tear. |
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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
Essential facts and insights aboutLabral Tear of the Right Shoulder
Alternative codes to consider when ruling out similar conditions
Documentation & Coding Risks
Avoid these common issues when documenting Labral Tear of the Right Shoulder.
Omitting laterality in documentation
Impact
Clinical: Potential for incorrect treatment, Regulatory: Non-compliance with coding standards, Financial: Delayed reimbursement
Mitigation
Always document 'right shoulder' in clinical notes
Using M25.511 alone for acute trauma
Impact
Reimbursement: May lead to claim denials, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate injury data
Mitigation
Pair with S43.431A for injury-specific coding
Incorrect encounter coding
Impact
Using initial encounter codes for follow-up visits
Mitigation
Educate staff on encounter-specific coding