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Diagnosis
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Procedure-CPT
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ICD10-Right
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ICD10-Left
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Shoulder
Pain
Stiffness
Sprain
Effusion
Contusion
Artificial Joint
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E/M Coding
Modifiers
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M25.511 Pain in right shoulder
M25.611 Stiffness of right shoulder
S43.491A Other sprain of right shoulder joint
M25.411 Effusion, right shoulder
S40.011A Contusion of right shoulder,
Z96.611 Presence of right artificial shoulder joint
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M25.512 Pain in left shoulder
M25.612 Stiffness of left shoulder
S43.492A Other sprain of left shoulder joint,
M25.412 Effusion, left shoulder
S40.012A Contusion of left shoulder,
Z96.612 Presence of left artificial shoulder joint
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Acromioclavicular Arthritis M19.019 715.11
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Distal Clavicle Resection 29824
CPT Coding
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M19.011 - Primary osteoarthritis, right
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M19.012 - Primary osteoarthritis, left
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Acromioclavicular Joint Separations S43.109A
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Acromioclavicular Joint Reconstruction 23552
CPT Coding
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S43.101A - Unspecified
S43.121A -100%-200% displacement
S43.131A - greater than 200%
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S43.102A - Unspecified
S43.122A -100%-200% displacement
S43.132A - greater than 200%
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Acromion Fracture S42.123A
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Acromion Fracture ORIF 23585
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S42.121A - Displaced right
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S42.122A - Displaced left
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Adhesive Capsulitis M75.00
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Arthroscopic Capsular Release 29825
CPT Coding
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M75.01 Adhesive capsulitis right shoulder
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M75.02 Adhesive capsulitis left shoulder
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Biceps Tendonitis M75.20
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Biceps Tenodesis 23430 29828
CPT Coding
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M75.21 Bicipital tendinitis, right shoulder
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M75.22 Bicipital tendinitis, left shoulder
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Bursitis of Shoulder M75.50
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Subacromial Decompression 29826
CPT Coding
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M75.51 Bursitis right shoulder
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M75.52 Bursitis left shoulder
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Calcific Tendinitis of the RTC M75.30
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M75.31 Calcific tendinitis right shoulder
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M75.32 Calcific tendinitis left shoulder
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Clavicle Fracture S42.023A 810.02
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Clavicle Fracture ORIF 23515
CPT Coding
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S42.021A Displaced fracture shaft right clavicle, initial closed
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S42.025A Nondisplaced fracture shaft left clavicle, initial closed
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Distal Clavicle Fracture S42.033A
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Clavicle Fracture ORIF 23515
CPT Coding
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S42.031A Displaced fracture lateral end right clavicle, initial closed
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S42.032A Displaced fracture lateral end left clavicle, initial closed
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Distal Clavicle Osteolysis M89.519
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Distal Clavicle Resection 29824
CPT Coding
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M89.511 Osteolysis, right shoulder
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M89.512 Osteolysis, left shoulder
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Glenohumeral Arthritis M19.019
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Total Shoulder Arthroplasty 23472
CPT Coding
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M19.011 Primary osteoarthritis, right shoulder
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M19.012 - Primary osteoarthritis, left shoulder
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Greater Tuberosity Fracture S42.253A
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Greater Tuberosity Fracture ORIF 23630
CPT codes
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S42.251A - Displaced fracture of greater tuberosity of right humerus
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S42.252A - Displaced fracture of greater tuberosity of left humerus
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Humeral Shaft Fracture S42.399A
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Humeral Shaft Fracture ORIF 24515
CPT Coding
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S42.341A Displaced spiral fracture shaft humerus, right arm, initial closed
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S42.342A Displaced spiral fracture shaft humerus, left arm, initial closed
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Proximal Humerus Fracture S42.209A
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Proximal Humerus Fracture ORIF 23615
CPT Codes
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S42.241A 4-part fracture surgical neck right humerus, initial closed
S42.201A - Unspecified
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42.242A 4-part fracture surgical neck left humerus, initial closed
S42.202A - Unspecified
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Rotator Cuff Strain S46.019A
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S46.011A Strain muscle(s) and tendon(s) the rotator cuff right shoulder, initial
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S46.012A Strain muscle(s) and tendon(s) the rotator cuff left shoulder, initial
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Rotator Cuff Tear (RTC) M75.120
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Rotator Cuff Repair 29827
CPT Coding
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M75.121 Complete rotator cuff tear or rupture right shoulder, not specified as traumatic
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M75.122 Complete rotator cuff tear or rupture left shoulder, not specified as traumatic
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Rotator Cuff Partial Thickness Tear M75.110
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Rotator Cuff Repair 29827
CPT Coding
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M75.111 Incomplete rotator cuff tear or rupture right shoulder, not specified as traumatic
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M75.112 Incomplete rotator cuff tear or rupture left shoulder, not specified as traumatic
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Shoulder Arthritis M19.019
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Total Shoulder Arthroplasty 23472
CPT Coding
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M19.011 Primary osteoarthritis, right shoulder
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M19.012 Primary osteoarthritis, left shoulder
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Shoulder Dislocation S43.016A
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S43.014A Anterior dislocation right humerus, initial
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S43.015A Anterior dislocation left humerus, initial
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Shoulder Pain
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M25.511 Pain in right shoulder
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M25.512 Pain in left shoulder
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SLAP Tear S43.439A
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SLAP Repair 29807
CPT Coding
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S43.431A
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S43.432A
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Stiffness in Shoulder
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M25.611
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M25.612
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Subacromial Impingement M75.50 726.10
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Subacromial Decompression 29826
CPT Coding
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M75.41 Impingement syndrome right shoulder
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M75.42 Impingement syndrome left shoulder
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see 7th Character Coding
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A=initial encounter, D=subsequent encounter, S=sequela
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