Pain, though often unwelcome, serves as the body’s alarm system, signaling that something might be amiss. In the realm of healthcare, precise diagnosis is the cornerstone of effective treatment, and the International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM) codes plays a crucial role in this process. This article explores the intricacies of ICD-10-CM diagnosis code M25.511, shedding light on right shoulder pain – a condition many have experienced but few truly understand.
M25.511 – The Key to Understanding Right Shoulder Pain
M25.511 is a specific ICD-10-CM code that pertains to right shoulder pain. Let’s break down this code to understand it better:
- “M” stands for Musculoskeletal and Connective Tissue.
- “25” represents disorders of the joint.
- “5” indicates “shoulder.”
- “11” specifies the laterality, in this case, “right.”
By deciphering this code, we can pinpoint the exact nature of the condition, the affected area, and its location – all essential information for healthcare professionals. Right shoulder pain, as indicated by M25.511, is a common complaint in the clinical setting.
2024 ICD-10-CM Diagnosis Code M25.511
- M25.511 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
- The 2024 edition of ICD-10-CM M25.511 became effective on October 1, 2023.
- This is the American ICD-10-CM version of M25.511 – other international versions of ICD-10 M25.511 may differ.
The following code(s) above M25.511 contain annotation back-references that may be applicable to M25.511:
- M00-M99 Diseases of the musculoskeletal system and connective tissue
- M20-M25 Other joint disorders
- M25 Other joint disorder, not elsewhere classified
- M25.5 Pain in joint
Approximate Synonyms
- Bilateral acromioclavicular joint pain
- Bilateral shoulder joint pain
- Bilateral shoulder joint pain > 3 months
- Bilateral shoulder joint pain greater than three months
- Bilateral sternoclavicular joint pain
- Pain of right acromioclavicular joint
- Pain of right shoulder joint
- Right acromioclavicular joint pain
- Right shoulder joint pain
- Right shoulder pain
- Right sternoclavicular joint pain
ICD-10-CM M25.511 is grouped within Diagnostic Related Group(s) (MS-DRG v41.0):
- 555 Signs and symptoms of musculoskeletal system and connective tissue with mcc
- 556 Signs and symptoms of musculoskeletal system and connective tissue without mcc
Convert M25.511 to ICD-9-CM Code History
- 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
- 2017 (effective 10/1/2016): No change
- 2018 (effective 10/1/2017): No change
- 2019 (effective 10/1/2018): No change
- 2020 (effective 10/1/2019): No change
- 2021 (effective 10/1/2020): No change
- 2022 (effective 10/1/2021): No change
- 2023 (effective 10/1/2022): No change
- 2024 (effective 10/1/2023): No change
Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.
ICD-10 Codes for Specific Causes of Right Shoulder Pain
While M25.511 serves as a general code for right shoulder pain, there are several more specific codes within the ICD-10-CM system that identify the underlying causes of this discomfort. Let’s explore some of these codes:
- Rotator Cuff Tendinitis (M75.1): This code specifies inflammation of the rotator cuff tendons, a common cause of right shoulder pain.
- Bursitis of the Shoulder (M75.3): When the bursae in the shoulder becomes inflamed, this code provides a precise diagnosis.
- Osteoarthritis of the Shoulder (M19.11): Osteoarthritis is a degenerative joint condition that can affect the shoulder and is represented by this code.
- Rheumatoid Arthritis of the Shoulder (M05.11): This code is used when rheumatoid arthritis specifically affects the shoulder joint.
- Frozen Shoulder (Adhesive Capsulitis) (M75.0): For patients suffering from a frozen shoulder, this code provides a clear diagnosis.
- Fracture of the Right Shoulder (S42.11): Traumatic fractures in the shoulder region can be coded with this classification.
- Dislocation of the Right Shoulder (S43.011): In cases of shoulder dislocation, healthcare providers use this code to record the diagnosis.
Conclusion
Right shoulder pain, as indicated by ICD-10-CM diagnosis code M25.511, is a common symptom with numerous potential underlying causes. Understanding the specific cause of right shoulder pain is vital for effective treatment and management. ICD-10 codes provide a structured system for healthcare providers to accurately diagnose and document the condition. Patients experiencing right shoulder pain should seek prompt medical evaluation to determine the underlying cause and develop a tailored treatment plan to alleviate discomfort and restore shoulder function.
