ICD-10 Coding for Lymphocytic Shoulder Strain(S46.011A, C85.92)
Complete ICD-10-CM coding and documentation guide for Lymphocytic Shoulder Strain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lymphocytic Shoulder Strain
S46.0-S46.9Primary Range
Injuries to the shoulder and upper arm
Covers shoulder strain and related injuries, including rotator cuff strains.
Impingement syndrome of shoulder
Relevant for chronic shoulder conditions that may involve immune responses.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| S46.011A | Strain of muscle(s) and tendon(s) of the rotator cuff of left shoulder, initial encounter | Use for acute traumatic shoulder strain without underlying immune condition. |
|
| C85.92 | Non-Hodgkin's lymphoma, unspecified, extranodal and solid organ sites | Use when shoulder pain is due to lymphocytic malignancy. |
|
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 lymphocytes shoulder strain
Essential facts and insights about Lymphocytic Shoulder Strain
Primary ICD-10-CM Codes for lymphocytes shoulder strain
Decision Criteria
clinical Criteria
- Acute injury with positive Neer/Hawkins tests
Applicable To
- Acute rotator cuff strain
Excludes
- Chronic shoulder pain (M25.512)
Clinical Validation Requirements
- MRI showing muscle/tendon tear without synovitis
Code-Specific Risks
- Misclassification if underlying condition is present.
Coding Notes
- Ensure documentation specifies acute injury mechanism.
C85.92 - Non-Hodgkin's lymphoma, unspecified, extranodal and solid organ sites
Use when shoulder pain is due to lymphocytic malignancy.
Applicable To
- Lymphoma involving shoulder
Excludes
- Benign lymphocytic infiltration
Clinical Validation Requirements
- Biopsy showing CD20+ lymphocytes
Coding Notes
Ensure malignancy is documented as primary condition.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lymphocytic Shoulder Strain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S46.011A.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure biopsy results are included in clinical notes.
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Identify and code the primary underlying condition first.
Impact
Risk of incorrect primary diagnosis coding.
Mitigation Strategy
Regular training on coding guidelines.
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 Lymphocytic Shoulder Strain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lymphocytic Shoulder Strain
Use these documentation templates to ensure complete and accurate documentation for Lymphocytic Shoulder Strain. These templates include all required elements for proper coding and billing.
Rheumatology Progress Note
Specialty: RheumatologyRequired Elements
- Subjective symptoms
- Objective findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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