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M75.10
ICD-10-CM
Rotator Cuff Tendinitis

Find information on Rotator Cuff Tendinitis diagnosis, including ICD-10 codes (M75.1, M75.11, M75.12), clinical documentation requirements, and healthcare coding guidelines. Learn about symptoms, treatment options, and best practices for accurate medical coding and billing related to Rotator Cuff Tendinopathy, Rotator Cuff Tear, Shoulder pain, and Supraspinatus Tendinitis. This resource helps healthcare professionals ensure proper documentation and coding for Rotator Cuff injuries.

Also known as

Shoulder Tendinitis
Rotator Cuff Syndrome
Shoulder Impingement Syndrome
+2 more

Diagnosis Snapshot

Key Facts
  • Definition : Inflammation of shoulder rotator cuff tendons, causing pain and limited movement.
  • Clinical Signs : Shoulder pain, weakness, stiffness, pain with overhead activities, clicking or popping.
  • Common Settings : Sports injuries, repetitive overhead work, age-related degeneration, trauma.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M75.10 Coding
M75.1-

Rotator cuff syndromes

Includes various rotator cuff disorders like tendinitis and tears.

M75.-

Shoulder lesions

Encompasses other shoulder problems excluding the acromioclavicular joint.

M00-M99

Diseases of the musculoskeletal system and connective tissue

Broad category covering many musculoskeletal and connective tissue disorders.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the rotator cuff tendinitis specified as calcific?

  • Yes

    Code M75.31 Rotator cuff calcific tendinitis

  • No

    Is laterality specified?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Rotator cuff inflammation
Rotator cuff tear
Adhesive capsulitis

Documentation Best Practices

Documentation Checklist
  • Document laterality (left/right shoulder)
  • Confirm rotator cuff tenderness/pain
  • Limited ROM abduction/external rotation
  • Exclude rotator cuff tear diagnosis
  • Pain with resisted strength testing

Coding and Audit Risks

Common Risks
  • Unspecified Tendinitis

    Coding unspecified tendinitis (M75.9) when documentation supports a more specific rotator cuff diagnosis (e.g., M75.11, M75.12) leads to undercoding and lost revenue.

  • Partial vs Full Tear

    Miscoding a partial rotator cuff tear (S46.0) as tendinitis (M75.1X) or vice versa can result in inaccurate severity reflection and claims denials.

  • Laterality Missing

    Omitting laterality (right, left, bilateral) when coding rotator cuff tendinitis (M75.1X) causes coding errors and impacts reimbursement.

Mitigation Tips

Best Practices
  • Document precise location, laterality, and severity for accurate ICD-10 coding (M75.1).
  • Thorough exam for ROM, pain, weakness crucial for CDI and CPT code selection (99202-99215).
  • Consistent, specific documentation supports medical necessity for compliance and reimbursement.
  • Correlate imaging findings (MRI) with physical exam in documentation for accurate diagnosis.
  • Detailed history including onset, mechanism, and activity limitations aids proper coding (726.1).

Clinical Decision Support

Checklist
  • Verify shoulder pain with overhead activity (ICD-10: M75.1)
  • Assess pain with palpation of rotator cuff (SNOMED CT: 249277008)
  • Evaluate range of motion limitations and pain arc (CPT: 99204)
  • Confirm absence of other shoulder pathologies (e.g., frozen shoulder)

Reimbursement and Quality Metrics

Impact Summary
  • Rotator Cuff Tendinitis Reimbursement: ICD-10 M75.1, CPT 20610 (injection), 97140 (PT), proper coding maximizes payment.
  • Coding Accuracy Impact: Precise ICD-10 and CPT coding for Rotator Cuff Tendinitis avoids denials, improves revenue cycle.
  • Hospital Reporting Impact: Accurate diagnosis data impacts quality metrics, resource allocation, and treatment outcome analysis.
  • Quality Metrics Impact: Tracking Rotator Cuff Tendinitis treatment success (pain reduction, ROM) influences value-based care reimbursement.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code M75.1 for unspecified shoulder
  • Document pain, weakness, limited ROM
  • Specify supraspinatus, infraspinatus, subscapularis or teres minor involvement for more specific codes
  • Consider laterality (right, left, bilateral)
  • Use modifiers for acute or chronic conditions

Documentation Templates

Patient presents with complaints of shoulder pain consistent with rotator cuff tendinitis.  The onset of pain was gradual, described as aching and worse with overhead activities and at night.  Patient denies any specific injury or trauma.  Keywords relevant to this presentation include rotator cuff pain, shoulder impingement syndrome, supraspinatus tendinopathy, infraspinatus tendinopathy, and subscapularis tendinopathy.  Physical examination reveals tenderness to palpation over the anterior and lateral aspects of the shoulder, positive Neer and Hawkins impingement signs, and painful arc of motion.  Strength testing demonstrates mild weakness in abduction and external rotation.  Differential diagnosis includes rotator cuff tear, frozen shoulder (adhesive capsulitis), bicipital tendinitis, and cervical radiculopathy.  Diagnostic considerations include shoulder x-ray to rule out bony pathology and assess for degenerative changes.  An MRI may be indicated if a rotator cuff tear is suspected.  Initial treatment plan includes rest, ice, compression, elevation (RICE), nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management, and physical therapy focusing on range of motion and rotator cuff strengthening exercises.  Patient education provided regarding activity modification and proper body mechanics.  Follow-up scheduled in two weeks to assess response to treatment.  ICD-10 code M75.11 (Rotator cuff tendinopathy or tendinitis, right shoulder) or M75.12 (Rotator cuff tendinopathy or tendinitis, left shoulder) is appropriate based on the affected side.  CPT codes for evaluation and management (E/M), physical therapy, and potential injections or imaging will be determined based on services rendered.