ICD-10 Coding for Labral Tear of the Right Shoulder(S43.431A, S43.431D, S43.431S)
Complete ICD-10-CM coding and documentation guide for Labral Tear 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 Labral Tear of the Right Shoulder
S43.431Primary Range
Superior glenoid labrum lesion, right shoulder
This range includes codes for initial, subsequent, and sequela encounters for right shoulder labral tears.
Code Comparison: When to Use Each Code
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. |
|
| S43.431D | Superior glenoid labrum lesion, right shoulder, subsequent encounter | Use for follow-up visits after initial treatment of a labral tear. |
|
| S43.431S | Superior glenoid labrum lesion, right shoulder, sequela | Use for chronic conditions resulting from a previous labral 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: ICD-10 code for right shoulder labral tear
Essential facts and insights about Labral Tear of the Right Shoulder
Primary ICD-10-CM Codes for labral tear right shoulder
Decision Criteria
clinical Criteria
- Confirmed SLAP tear via MRI
documentation Criteria
- Documentation must specify 'right shoulder' and 'initial encounter'
Applicable To
- Acute SLAP tear
Excludes
- Bankart lesion (S43.421A)
Clinical Validation Requirements
- MRI with contrast confirming SLAP tear
- Positive O'Brien's test
Code-Specific Risks
- Incorrectly using for subsequent encounters
Coding Notes
- Ensure laterality and encounter type are documented.
S43.431D - Superior glenoid labrum lesion, right shoulder, subsequent encounter
Use for follow-up visits after initial treatment of a labral tear.
Applicable To
- Follow-up care for SLAP tear
Clinical Validation Requirements
- Ongoing treatment documentation
Coding Notes
Ensure documentation reflects ongoing care.
S43.431S - Superior glenoid labrum lesion, right shoulder, sequela
Use for chronic conditions resulting from a previous labral tear.
Applicable To
- Chronic instability post-SLAP repair
Clinical Validation Requirements
- Documentation of chronic symptoms or complications
Coding Notes
Document the specific sequela and its impact.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pain in right shoulder
M25.511Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Bankart lesion, right shoulder
S43.421ADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Labral Tear of the Right Shoulder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S43.431A.
Impact
Clinical: Potential for incorrect treatment, Regulatory: Non-compliance with coding standards, Financial: Delayed reimbursement
Mitigation Strategy
Always document 'right shoulder' in clinical notes
Impact
Reimbursement: May lead to claim denials, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate injury data
Mitigation Strategy
Pair with S43.431A for injury-specific coding
Impact
Using initial encounter codes for follow-up visits
Mitigation Strategy
Educate staff on encounter-specific coding
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 Labral Tear of the Right Shoulder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Labral Tear of the Right Shoulder
Use these documentation templates to ensure complete and accurate documentation for Labral Tear of the Right Shoulder. These templates include all required elements for proper coding and billing.
Post-operative follow-up for SLAP repair
Specialty: OrthopedicsRequired Elements
- Patient's progress
- Healing status
- Physical therapy notes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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