ICD-10 Coding for Scapular Dyskinesis(M25.512, S43.431)
Complete ICD-10-CM coding and documentation guide for Scapular Dyskinesis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Scapular Dyskinesis
M75-M79Primary Range
Other soft tissue disorders
This range includes conditions related to shoulder and scapular dysfunctions, which are relevant for coding underlying causes of scapular dyskinesis.
Injuries to the shoulder and upper arm
This range includes traumatic injuries that can lead to scapular dyskinesis, such as AC joint dislocation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M25.512 | Pain in left shoulder | Use when chronic shoulder pain is directly linked to scapular dyskinesis. |
|
| S43.431 | Traumatic rupture of AC joint, right shoulder | Use when scapular dyskinesis is secondary to a traumatic AC joint injury. |
|
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 scapular dyskinesis
Essential facts and insights about Scapular Dyskinesis
Primary ICD-10-CM Codes for scapular dyskinesis
Decision Criteria
clinical Criteria
- Chronic shoulder pain with scapular dyskinesis observed
coding Criteria
- Pain persists beyond 3 months
Applicable To
- Chronic shoulder pain with scapular dyskinesis
Excludes
- Pain due to fracture or dislocation
Clinical Validation Requirements
- Chronic pain persisting over 3 months
- Observed scapular dysrhythmia during physical examination
Code-Specific Risks
- Misclassification if not linked to a primary condition
Coding Notes
- Ensure documentation links scapular dyskinesis to the primary shoulder condition.
S43.431 - Traumatic rupture of AC joint, right shoulder
Use when scapular dyskinesis is secondary to a traumatic AC joint injury.
Applicable To
- AC joint dislocation causing scapular dyskinesis
Excludes
- Non-traumatic AC joint issues
Clinical Validation Requirements
- Documented trauma history
- Positive Scapular Retraction Test
Coding Notes
Ensure trauma is documented as the cause of the dyskinesis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Kinetic chain dysfunction
R29.891Differential 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 Scapular Dyskinesis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M25.512.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Thorough patient history, Comprehensive physical examination
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always code the primary condition causing dyskinesis first.
Impact
Failure to sequence primary conditions first.
Mitigation Strategy
Regular training on ICD-10 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 Scapular Dyskinesis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Scapular Dyskinesis
Use these documentation templates to ensure complete and accurate documentation for Scapular Dyskinesis. These templates include all required elements for proper coding and billing.
Chronic shoulder pain with scapular dyskinesis
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Linkage to primary condition
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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