ICD-10 Coding for Adhesive Capsulitis of the Right Shoulder(M75.01)
Complete ICD-10-CM coding and documentation guide for Adhesive Capsulitis of the Right Shoulder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Adhesive Capsulitis of the Right Shoulder
M75.0-M75.9Primary Range
Shoulder lesions
This range includes codes for various shoulder lesions, with M75.01 specifically for adhesive capsulitis of the right shoulder.
Key Information: ICD-10 code for adhesive capsulitis right shoulder
Essential facts and insights about Adhesive Capsulitis of the Right Shoulder
Primary ICD-10-CM Code for adhesive capsulitis right shoulder
Decision Criteria
clinical Criteria
- Presence of global ROM restriction and pain
documentation Criteria
- Documented ROM measurements and symptom duration
Applicable To
- Frozen shoulder of right shoulder
Excludes
- M25.512 - Pain in right shoulder
Clinical Validation Requirements
- Global loss of passive ROM in ≥3 planes
- Pain at extremes of motion
- ≥3 months symptom duration
Code-Specific Risks
- Incorrectly coding general shoulder pain instead of adhesive capsulitis
- Failing to document specific ROM limitations
Coding Notes
- Ensure documentation includes specific ROM measurements and duration of symptoms.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Adhesive capsulitis of unspecified shoulder
M75.00Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Adhesive Capsulitis of the Right Shoulder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M75.01.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Include specific ROM limitations., Document symptom duration.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use M75.01 when ROM limitation is documented.
Impact
Lack of specific ROM documentation may trigger audits.
Mitigation Strategy
Ensure detailed ROM measurements are included in patient records.
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 Adhesive Capsulitis of the Right Shoulder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Adhesive Capsulitis of the Right Shoulder
Use these documentation templates to ensure complete and accurate documentation for Adhesive Capsulitis of the Right Shoulder. These templates include all required elements for proper coding and billing.
Orthopedic Evaluation
Specialty: OrthopedicsRequired Elements
- ROM measurements
- Pain assessment
- Symptom duration
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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