ICD-10 Coding for Right Rotator Cuff Tendinitis(M75.311, M75.321)
Complete ICD-10-CM coding and documentation guide for Right Rotator Cuff Tendinitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Rotator Cuff Tendinitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M75.311 | Tendinitis of right supraspinatus | Use when documentation specifies tendinitis of the right supraspinatus tendon. |
|
| M75.321 | Tendinitis of right infraspinatus | Use when documentation specifies tendinitis of the right infraspinatus tendon. |
|
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 rotator cuff tendinitis
Essential facts and insights about Right Rotator Cuff Tendinitis
Primary ICD-10-CM Codes for right rotator cuff tendinitis
Decision Criteria
clinical Criteria
- Presence of supraspinatus tendon pain and positive clinical tests.
documentation Criteria
- Documentation must specify the supraspinatus tendon.
Applicable To
- Right supraspinatus tendinitis
Clinical Validation Requirements
- Pain localized to supraspinatus insertion
- Positive empty can test
- Thickening on ultrasound
Code-Specific Risks
- Confusion with rotator cuff tear codes
- Misclassification as impingement syndrome
Coding Notes
- Ensure documentation specifies the tendon involved for accurate coding.
M75.321 - Tendinitis of right infraspinatus
Use when documentation specifies tendinitis of the right infraspinatus tendon.
Applicable To
- Right infraspinatus tendinitis
Excludes
- Rotator cuff tear (M75.1-)
- Impingement syndrome (M75.4-)
Clinical Validation Requirements
- Pain localized to infraspinatus
- Positive external rotation resistance test
- Thickening on ultrasound
Coding Notes
Ensure documentation specifies the tendon involved for accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other shoulder lesions, right shoulder
M75.81Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Impingement syndrome of right shoulder
M75.41Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Rotator Cuff Tendinitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M75.311.
Impact
Clinical: Lack of specificity can lead to misdiagnosis., Regulatory: May result in coding errors and compliance issues., Financial: Can lead to claim denials or incorrect reimbursement.
Mitigation Strategy
Ensure thorough clinical documentation., Include specific tests and imaging results.
Impact
Reimbursement: Incorrect coding can lead to denied claims or incorrect DRG assignment., Compliance: Misclassification can result in audits and compliance issues., Data Quality: Impacts the accuracy of clinical data and patient records.
Mitigation Strategy
Ensure documentation specifies tendinitis and the specific tendon involved.
Impact
Lack of specificity in documentation can lead to audit findings.
Mitigation Strategy
Ensure detailed documentation specifying the tendon and clinical findings.
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 Right Rotator Cuff Tendinitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Rotator Cuff Tendinitis
Use these documentation templates to ensure complete and accurate documentation for Right Rotator Cuff Tendinitis. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for right shoulder pain
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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