Facebook tracking pixel
M75.100
ICD-10-CM
Rotator Cuff Tendinopathy

Find information on Rotator Cuff Tendinopathy diagnosis, including ICD-10 codes (M75.1-, S46.0-), clinical documentation requirements, and healthcare coding guidelines. Learn about rotator cuff tears, impingement syndrome, and other related shoulder pain conditions. Explore resources for medical professionals on proper coding, billing, and documentation for rotator cuff tendinopathy treatment and rehabilitation. This resource offers valuable information for physicians, coders, and other healthcare providers.

Also known as

Rotator Cuff Tendinitis
Shoulder Tendinitis
Supraspinatus Tendinitis

Diagnosis Snapshot

Key Facts
  • Definition : Shoulder pain caused by irritated or damaged rotator cuff tendons.
  • Clinical Signs : Pain with overhead reaching, weakness, stiffness, clicking or popping.
  • Common Settings : Sports injuries, repetitive overhead work, age-related degeneration.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M75.100 Coding
M75.1

Rotator cuff syndromes

Includes rotator cuff tendinopathy and other related disorders.

M75.8

Other specified shoulder lesions

Use when rotator cuff tendinopathy not specified elsewhere.

M75.9

Unspecified shoulder lesion

Use when the specific shoulder lesion is not documented.

M25.5

Pain in joint

Can be used if tendinopathy is causing pain in the shoulder joint.

Code-Specific Guidance

Decision Tree for

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

Full rupture of rotator cuff?

  • Yes

    Which tendon?

  • No

    Impingement syndrome present?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Rotator cuff tendon pain/inflammation
Rotator cuff tear
Adhesive capsulitis

Documentation Best Practices

Documentation Checklist
  • Rotator cuff tendinopathy diagnosis documented
  • Laterality (left/right shoulder) specified
  • Symptom onset, duration, and character documented
  • Physical exam findings (e.g., pain, ROM) noted
  • ICD-10 code (e.g., M75.1) assigned and justified

Coding and Audit Risks

Common Risks
  • Unspecified Tendinopathy

    Coding with unspecified rotator cuff tendinopathy (M75.1-) when documentation supports a more specific diagnosis (e.g., tear, calcific tendinitis) leads to undercoding and lost revenue.

  • Lateral Epicondylitis Confusion

    Miscoding lateral epicondylitis (tennis elbow, M77.11) as rotator cuff tendinopathy due to similar symptoms can cause inaccurate reporting and claims denials.

  • Missing Laterality

    Failing to document and code laterality (right, left, bilateral) for rotator cuff tendinopathy (M75.1-) impacts reimbursement and data accuracy for quality reporting.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding (M75.1-, S46.0-) for Rotator Cuff Tendinopathy
  • Thorough documentation of pain, weakness, ROM for CDI, compliance
  • Specific physical exam findings: Neer, Hawkins tests crucial for diagnosis
  • Correlate imaging (ultrasound/MRI) findings with symptoms in documentation
  • Clearly document failed conservative treatment for surgical pre-authorization

Clinical Decision Support

Checklist
  • Painful arc test positive or painful resisted external rotation
  • Subacromial impingement on exam or imaging
  • Exclude other shoulder diagnoses e.g. adhesive capsulitis
  • Document symptom duration and severity for accurate coding
  • Patient education on activity modification and pain management

Reimbursement and Quality Metrics

Impact Summary
  • Rotator Cuff Tendinopathy Reimbursement: ICD-10 M75.1-, CPT 29827, 23410 impacts accurate billing.
  • Coding accuracy: Precise documentation of laterality, acuteness, stage affects payment, reduces denials.
  • Hospital reporting: Rotator cuff surgery data impacts quality metrics for surgical site infections.
  • Quality metrics impact: Functional outcomes, pain scores crucial for 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 rotator cuff tear with M75.1xx
  • Specify laterality: right/left/bilateral
  • Document pain, weakness, impingement
  • For partial tears, add S46.0xx
  • Confirm imaging supports diagnosis

Documentation Templates

Patient presents with complaints consistent with rotator cuff tendinopathy, also known as rotator cuff tendonitis,  impacting the shoulder.  Symptoms include shoulder pain, especially with overhead activities and at night,  weakness, and limited range of motion.  Onset of symptoms was gradual and reported as [duration].  Pain is localized to the [location: e.g., anterior, lateral, posterior] aspect of the shoulder and is described as [character: e.g., aching, sharp, burning].  Patient denies any specific injury but reports [activity/activities] that may have contributed to the condition.  Physical examination reveals [positive/negative] Neer impingement sign, [positive/negative] Hawkins-Kennedy test, and painful arc of motion.  Strength testing demonstrates [strength level] of the rotator cuff muscles.  Differential diagnoses considered include rotator cuff tear, adhesive capsulitis (frozen shoulder), and cervical radiculopathy.  Assessment is rotator cuff tendinopathy (ICD-10 code M75.1).  Plan includes conservative management with rest, ice, compression, elevation (RICE), nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, physical therapy focusing on range of motion and rotator cuff strengthening exercises, and activity modification.  Patient education provided on proper body mechanics and home exercise program.  Follow-up appointment scheduled in [duration] to assess response to treatment.  Referral to orthopedic specialist will be considered if symptoms do not improve with conservative management.
Rotator Cuff Tendinopathy - AI-Powered ICD-10 Documentation