ICD-10 Coding for Tear of Rotator Cuff(M75.1, M75.11, M75.11I)
Learn how to accurately code rotator cuff tears with ICD-10, including traumatic and non-traumatic classifications, documentation requirements, and billing considerations.
Complete code families applicable to Tear of Rotator Cuff
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M75.11 | Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic | Use when imaging confirms partial tear without trauma history. |
|
| S46.011A | Strain of muscle(s) and tendon(s) of the rotator cuff of right shoulder, initial encounter | Use when there is a documented traumatic event leading to the tear. |
|
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 aboutTear of Rotator Cuff
Alternative codes to consider when ruling out similar conditions
Documentation & Coding Risks
Avoid these common issues when documenting Tear of Rotator Cuff.
Omitting laterality in documentation
Impact
Clinical: Leads to incomplete diagnosis, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation
Always specify right or left in notes, Double-check imaging reports for laterality
Confusing traumatic and non-traumatic codes
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification may result in compliance issues., Data Quality: Affects the accuracy of clinical data.
Mitigation
Verify the presence or absence of a traumatic event in documentation.
Trauma documentation
Impact
Lack of clear documentation of traumatic events can lead to audit issues.
Mitigation
Ensure all traumatic events are clearly documented in patient history.
Frequently Asked Questions
Primary Code
Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumaticon-