ICD-10 Coding for Frozen Shoulder(M75.01, M75.02, M75.00)
Complete ICD-10-CM coding and documentation guide for Frozen Shoulder. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Frozen Shoulder
M75.0-M75.02Primary Range
Adhesive capsulitis of shoulder
This range covers all codes related to adhesive capsulitis of the shoulder, including laterality-specific codes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M75.01 | Adhesive capsulitis of right shoulder | Use when adhesive capsulitis is confirmed in the right shoulder with clinical and imaging evidence. |
|
| M75.02 | Adhesive capsulitis of left shoulder | Use when adhesive capsulitis is confirmed in the left shoulder with clinical and imaging evidence. |
|
| M75.00 | Adhesive capsulitis of unspecified shoulder | Use only if laterality cannot be determined after thorough evaluation. |
|
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 adhesive capsulitis
Essential facts and insights about Frozen Shoulder
Primary ICD-10-CM Codes for shoulder adhesive capsulitis
Decision Criteria
clinical Criteria
- Presence of significant ROM loss and pain in the right shoulder.
Applicable To
- Frozen shoulder, right
Clinical Validation Requirements
- MRI shows capsular thickening ≥7mm
- Coracohumeral ligament thickness ≥4mm
Code-Specific Risks
- Incorrect laterality documentation can lead to audits.
Coding Notes
- Ensure laterality is documented clearly to avoid unspecified coding.
M75.02 - Adhesive capsulitis of left shoulder
Use when adhesive capsulitis is confirmed in the left shoulder with clinical and imaging evidence.
Applicable To
- Frozen shoulder, left
Excludes
- Rotator cuff tear (M75.1)
- Primary osteoarthritis (M19.012)
Clinical Validation Requirements
- MRI shows capsular thickening ≥7mm
- Coracohumeral ligament thickness ≥4mm
Coding Notes
Ensure laterality is documented clearly to avoid unspecified coding.
M75.00 - Adhesive capsulitis of unspecified shoulder
Use only if laterality cannot be determined after thorough evaluation.
Applicable To
- Frozen shoulder, unspecified
Excludes
- Rotator cuff tear (M75.1)
- Primary osteoarthritis (M19.019)
Clinical Validation Requirements
- Patient reports bilateral stiffness; unable to determine laterality due to cognitive impairment.
Coding Notes
Avoid using unless absolutely necessary; document attempts to determine laterality.
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.
Rotator cuff tear or rupture
M75.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Frozen Shoulder to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M75.01.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always verify and document the affected side., Use templates that prompt for laterality.
Impact
Reimbursement: Potential denials or reduced reimbursement., Compliance: Increased audit risk., Data Quality: Decreased accuracy in clinical data.
Mitigation Strategy
Always document and code the specific side affected.
Impact
High audit risk when using M75.00 due to unspecified laterality.
Mitigation Strategy
Document specific shoulder involvement and use laterality-specific codes.
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 Frozen Shoulder, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Frozen Shoulder
Use these documentation templates to ensure complete and accurate documentation for Frozen Shoulder. These templates include all required elements for proper coding and billing.
Orthopedic evaluation of adhesive capsulitis
Specialty: OrthopedicsRequired Elements
- Laterality
- Stage of capsulitis
- Range of motion measurements
- Imaging findings
- Functional limitations
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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