ICD-10 Coding for Chronic Right Shoulder Pain(M25.511, G89.29)
Complete ICD-10-CM coding and documentation guide for Chronic Right Shoulder Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Right Shoulder Pain
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M25.511 | Pain in right shoulder | Use when documenting chronic pain specifically located in the right shoulder. |
|
| G89.29 | Other chronic pain | Use when the encounter is primarily for chronic pain management. |
|
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 chronic right shoulder pain
Essential facts and insights about Chronic Right Shoulder Pain
Primary ICD-10-CM Codes for chronic right shoulder pain
Decision Criteria
clinical Criteria
- Pain localized to the right shoulder for more than 3 months.
documentation Criteria
- Explicit mention of 'chronic' in the medical record.
Applicable To
- Right shoulder joint pain
Excludes
- Pain due to internal derangement of shoulder (M75.-)
Clinical Validation Requirements
- Documented pain in the right shoulder lasting more than 3 months
- Physical exam findings indicating shoulder pain
- Imaging results supporting shoulder pathology
Code-Specific Risks
- Ensure chronicity is documented to avoid incorrect coding.
Coding Notes
- Ensure documentation specifies 'chronic' and includes duration.
G89.29 - Other chronic pain
Use when the encounter is primarily for chronic pain management.
Applicable To
- Chronic pain not elsewhere classified
Excludes
- Chronic pain syndrome (G89.4)
Clinical Validation Requirements
- Chronic pain documented without a specific underlying condition
- Pain management as the primary focus of the encounter
Coding Notes
Sequence first when the encounter is for pain management.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Adhesive capsulitis of right shoulder
M75.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Right Shoulder Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M25.511.
Impact
Clinical: Inaccurate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always include 'chronic' and duration in documentation., Review coding guidelines regularly.
Impact
Reimbursement: May lead to claim denials if chronicity is not documented., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Ensure documentation includes 'chronic' and duration.
Impact
Inadequate documentation of chronicity can lead to audit issues.
Mitigation Strategy
Ensure all records include 'chronic' and duration.
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 Chronic Right Shoulder Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Right Shoulder Pain
Use these documentation templates to ensure complete and accurate documentation for Chronic Right Shoulder Pain. These templates include all required elements for proper coding and billing.
Chronic Right Shoulder Pain Management
Specialty: OrthopedicsRequired Elements
- History of present illness
- Physical exam findings
- Imaging results
- Pain management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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