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Writer's pictureAndrea Ryan

Complete Guide to ICD-10 Codes for the Shoulder Joint

There are several disorders of the shoulder joint that can be treated with physical therapy. Treatment for these conditions can be effective, helping to improve range of motion, reduce pain and inflammation, and improve strength and function in the shoulder joint. Some forms of treatment recommended by physical therapists may include exercises, stretches, manual therapy, and modalities such as heat or ice therapy.


In this article, we will continue our exploration of the ICD-10 codes used to bill for the diagnosis and treatment of pain or disorder in specific areas of the body. Please find a comprehensive list of the conditions treated most commonly by therapists in the shoulder joint:



Bursitis of the Shoulder:


Shoulder bursitis is a condition in which the bursa, a small fluid-filled sac that cushions the joint, becomes inflamed. This can cause pain, stiffness, and limited range of motion in the shoulder.


To diagnose shoulder bursitis, a healthcare provider will typically begin with a physical exam, asking about the patient's symptoms and medical history. They may also order imaging tests such as X-rays, ultrasounds, or MRI to confirm the diagnosis and rule out other possible causes of shoulder pain.


The treatment of shoulder bursitis generally involves a combination of rest, physical therapy, and medication. Physical therapy exercises can help improve range of motion and strength in the shoulder, and can also help prevent future episodes of bursitis. Exercises may include gentle stretches, strengthening exercises, and range-of-motion exercises.


Physical therapy can be a very effective treatment for shoulder bursitis, as it can help to reduce pain, improve range of motion, and strengthen the muscles in the shoulder.


A physical therapist will typically begin by assessing the patient's range of motion, strength, and level of pain. They will then create a personalized treatment plan that may include the following:


  • Stretching exercises: Gentle stretching exercises can help to improve flexibility and range of motion in the shoulder joint. The therapist may use manual techniques or recommend specific stretches for the patient to do at home.


  • Strengthening exercises: Strengthening exercises can help to improve the strength and stability of the muscles in the shoulder, which can help to prevent future episodes of bursitis. The therapist may use weights, resistance bands, or other equipment to target specific muscles.


  • Posture and body mechanics: The therapist may teach the patient proper posture and body mechanics to help reduce stress on the shoulder joint and prevent further injury.


  • Modalities: The therapist may also use modalities such as ice or heat therapy, ultrasound, or electrical stimulation to help reduce pain and inflammation.


  • Activity modification: The therapist may also recommend modifications to the patient's daily activities to avoid aggravating the shoulder joint.


  • Home exercise program: The therapist will provide the patient with a customized home exercise program to continue the progress made in physical therapy.


It is important to note that every patient's treatment plan will be different, and the duration and intensity of physical therapy will depend on the severity of the bursitis and the individual patient's needs.


Surgery is generally only recommended in severe cases of shoulder bursitis that do not respond to other treatments. Your healthcare provider will be able to recommend the best course of treatment for your individual needs.


The following are some possible ICD-10 codes for shoulder bursitis:

  • M75.40 - Unspecified shoulder bursitis

  • M75.41 - Bursitis of the shoulder, right shoulder

  • M75.42 - Bursitis of the shoulder, left shoulder

  • M75.43 - Bursitis of the shoulder, bilateral

  • M71.20 - Other specified bursitis, unspecified shoulder

  • M71.21 - Other specified bursitis, right shoulder

  • M71.22 - Other specified bursitis, left shoulder

  • M71.23 - Other specified bursitis, bilateral shoulder


Separated Shoulder:


A separated shoulder is a common injury that occurs when the ligaments that hold the collarbone (clavicle) to the shoulder blade (scapula) are stretched or torn, resulting in a partial or complete separation of the two bones. It is often caused by a direct blow to the shoulder or a fall onto an outstretched arm.


Symptoms of a separated shoulder include pain, swelling, bruising, and limited range of motion in the affected shoulder. Treatment typically involves rest, ice, and pain medication, followed by physical therapy to regain strength and mobility in the shoulder. In severe cases, surgery may be required to repair the damaged ligaments.


Physical therapy can be an effective treatment for a separated shoulder. The goals of physical therapy are to reduce pain and inflammation, restore range of motion, and improve strength and stability in the affected shoulder. Here are some common physical therapy treatments for a separated shoulder:


  • Ice and heat therapy: alternating between ice and heat can help reduce pain and inflammation in the shoulder.


  • Range of motion exercises: gentle exercises to move the shoulder joint through its full range of motion can help prevent stiffness and promote healing.


  • Strengthening exercises: exercises to strengthen the muscles around the shoulder joint can help improve stability and prevent further injury.


  • Manual therapy: hands-on techniques such as massage, mobilization, and stretching can help improve flexibility and reduce pain.


  • Electrical stimulation: electrical stimulation can help improve muscle strength and reduce pain.


  • Taping or bracing: taping or bracing the shoulder can provide support and help prevent further injury.


  • Education and advice: a physical therapist can provide education and advice on proper posture, body mechanics, and exercises to prevent future shoulder injuries.


It's important to work closely with a physical therapist to develop a personalized treatment plan based on your specific needs and goals.


The ICD-10 codes used to diagnose separated shoulder are:

  • S43.00 - Unspecified dislocation of right shoulder joint

  • S43.01 - Unspecified dislocation of left shoulder joint

  • S43.02 - Unspecified dislocation of unspecified shoulder joint

  • S43.03 - Subluxation of acromioclavicular joint, unspecified shoulder

  • S43.031 - Subluxation of acromioclavicular joint, right shoulder

  • S43.032 - Subluxation of acromioclavicular joint, left shoulder

  • S43.039 - Subluxation of acromioclavicular joint, unspecified shoulder

  • S43.1 - Dislocation of acromioclavicular joint

  • S43.10 - Dislocation of unspecified acromioclavicular joint

  • S43.11 - Dislocation of right acromioclavicular joint

  • S43.12 - Dislocation of left acromioclavicular joint

  • S43.8 - Other dislocation of shoulder girdle

  • S43.80 - Other specified dislocation of unspecified shoulder girdle

  • S43.81 - Other specified dislocation of right shoulder girdle

  • S43.82 - Other specified dislocation of left shoulder girdle

  • S43.9 - Dislocation of shoulder, unspecified

  • S43.90 - Unspecified dislocation of unspecified shoulder

  • S43.91 - Unspecified dislocation of right shoulder

  • S43.92 - Unspecified dislocation of left shoulder


Osteoarthritis of the Shoulder:


Osteoarthritis of the shoulder is a degenerative joint disease that affects the cartilage in the shoulder joint. Cartilage is a smooth, slippery tissue that covers the ends of bones and allows them to move smoothly against each other. In osteoarthritis, the cartilage in the shoulder joint gradually wears away over time, leading to pain, stiffness, and limited range of motion in the shoulder.


Osteoarthritis of the shoulder is most commonly seen in people over the age of 50, and is more common in women than in men. It can be caused by a variety of factors, including age, genetics, previous injuries or trauma to the shoulder joint, and repetitive use of the shoulder joint.


Symptoms of osteoarthritis of the shoulder include pain, stiffness, and loss of range of motion in the shoulder joint. The pain is usually a dull ache that is worsened by movement of the arm. As the condition progresses, the pain may become more constant and severe, and may be accompanied by swelling and inflammation.


Treatment for osteoarthritis of the shoulder may include a combination of medication, physical therapy, and lifestyle modifications. In severe cases, surgery may be necessary to replace or repair the damaged joint.


Physical therapy can be an effective treatment for osteoarthritis of the shoulder. The goals of physical therapy are to reduce pain, improve range of motion, and increase strength and stability in the affected shoulder. Here are some common physical therapy treatments for osteoarthritis of the shoulder:


  • Range of motion exercises: gentle exercises to move the shoulder joint through its full range of motion can help prevent stiffness and promote healing.


  • Strengthening exercises: exercises to strengthen the muscles around the shoulder joint can help improve stability and support the joint, reducing pain and preventing further damage.


  • Manual therapy: hands-on techniques such as massage, mobilization, and stretching can help improve flexibility and reduce pain.


  • Heat or ice therapy: applying heat or ice to the shoulder can help reduce pain and inflammation.


  • Posture and body mechanics: a physical therapist can teach proper posture and body mechanics to reduce stress on the shoulder joint and prevent further damage.


  • Assistive devices: using assistive devices such as slings, braces, or canes can help support the shoulder joint and reduce pain.


It's important to work closely with a physical therapist to develop a personalized treatment plan based on your specific needs and goals. The therapist may also recommend lifestyle modifications, such as weight loss or modifications to daily activities, to help reduce stress on the shoulder joint and improve overall function


The ICD-10 codes for osteoarthritis of the shoulder are:

  • M19.011 - Primary osteoarthritis, right shoulder

  • M19.012 - Primary osteoarthritis, left shoulder

  • M19.019 - Primary osteoarthritis, unspecified shoulder

  • M19.111 - Post-traumatic osteoarthritis, right shoulder

  • M19.112 - Post-traumatic osteoarthritis, left shoulder

  • M19.119 - Post-traumatic osteoarthritis, unspecified shoulder

  • M19.211 - Traumatic arthropathy, right shoulder

  • M19.212 - Traumatic arthropathy, left shoulder

  • M19.219 - Traumatic arthropathy, unspecified shoulder

  • M19.90 - Unspecified osteoarthritis, unspecified shoulder

  • M19.91 - Unspecified osteoarthritis, right shoulder

  • M19.92 - Unspecified osteoarthritis, left shoulder


Frozen Shoulder:


A frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain and stiffness in the shoulder joint. It occurs when the capsule that surrounds the shoulder joint becomes thick and tight, which can limit range of motion and cause pain.


A diagnosis of frozen shoulder typically means that a healthcare professional, such as a doctor or physical therapist, has determined that you have limited range of motion in your shoulder joint and experience pain or stiffness that is consistent with the symptoms of frozen shoulder. They may also perform physical examinations and imaging tests, such as X-rays or MRI, to rule out other conditions that may be causing the symptoms.


There are several potential causes of frozen shoulder, including injury, surgery, diabetes, and other medical conditions. The condition may occur in three stages: freezing, frozen, and thawing. During the freezing stage, the shoulder gradually becomes stiff and painful. In the frozen stage, the stiffness and pain may become more severe, and range of motion in the shoulder joint may be severely limited. In the thawing stage, the pain and stiffness gradually improve, and range of motion may slowly return.


Treatment for frozen shoulder may include physical therapy, medication, and sometimes surgery. The goal of treatment is to relieve pain and stiffness, and to restore range of motion in the affected shoulder. It's important to work closely with a healthcare professional to develop a personalized treatment plan based on your specific needs and goals.


Physical therapy is an important component of treatment for a frozen shoulder. The goal of physical therapy is to improve range of motion, decrease pain and stiffness, and prevent the condition from recurring.


The ICD-10 codes for adhesive capsulitis, also known as frozen shoulder, are:

  • M75.0 - Adhesive capsulitis of shoulder

  • M75.00 - Adhesive capsulitis of unspecified shoulder

  • M75.01 - Adhesive capsulitis of right shoulder

  • M75.02 - Adhesive capsulitis of left shoulder


Rotator Cuff Tears:


A diagnosis of a rotator cuff tear means that one or more of the tendons that attach the muscles of the rotator cuff to the shoulder bone have been torn. The rotator cuff is a group of four muscles and their tendons that connect the upper arm bone to the shoulder blade. The rotator cuff helps to stabilize the shoulder joint and enables the arm to rotate and lift.


Rotator cuff tears can occur as a result of an injury, such as a fall or a sports injury, or they can develop over time as part of the natural aging process. Some common symptoms of a rotator cuff tear include pain in the shoulder, weakness in the arm, and difficulty lifting the arm or performing certain activities.


A healthcare professional, such as an orthopedic surgeon, may perform a physical examination and imaging tests, such as an MRI or ultrasound, to confirm the diagnosis of a rotator cuff tear. The severity and location of the tear will help determine the appropriate treatment plan.


Treatment options for a rotator cuff tear may include:


  • Non-surgical treatments: Non-surgical treatments for a rotator cuff tear may include rest, ice, physical therapy, and medications to relieve pain and inflammation.


  • Surgery: If non-surgical treatments do not provide relief, surgery may be necessary. Surgical options may include arthroscopic repair or open surgery to repair or reattach the torn tendon.


The choice of treatment depends on several factors, including the severity of the tear, the patient's age, overall health, and personal preferences. A healthcare professional can help determine the most appropriate treatment plan for each individual.


An acute rotator cuff tear is a sudden and severe tear in one or more of the tendons that attach the muscles of the rotator cuff to the shoulder bone. This type of tear usually occurs as a result of a sudden injury or trauma, such as a fall, lifting a heavy object, or a sports injury. Acute tears typically cause immediate pain and weakness in the arm, and may require immediate medical attention.


On the other hand, a chronic rotator cuff tear develops gradually over time and may not be immediately noticeable. Chronic tears are often the result of degenerative changes in the rotator cuff tendons due to aging, overuse, or repetitive stress. Symptoms of a chronic tear may include shoulder pain, weakness, and limited range of motion, but these symptoms may be mild or intermittent.


The treatment for acute and chronic rotator cuff tears may differ. Acute tears may require immediate medical attention, and surgery may be necessary to repair the torn tendon. Non-surgical treatments such as rest, ice, physical therapy, and medications to relieve pain and inflammation may also be recommended.


For chronic tears, non-surgical treatments such as physical therapy and medication may be initially recommended to manage pain and improve function. However, if the tear is severe or causing significant symptoms, surgery may be necessary to repair or reattach the tendon.


In general, the prognosis for acute and chronic rotator cuff tears may differ. Acute tears that are treated promptly may have a better chance of healing and returning to normal function, while chronic tears may require more extensive treatment and may have a longer recovery period.


The ICD-10 codes for rotator cuff tears are:

  • M75.1 - Rotator cuff tear or rupture, not specified as traumatic

  • M75.10 - Unspecified rotator cuff tear or rupture, not specified as traumatic

  • M75.11 - Partial rotator cuff tear or rupture, not specified as traumatic

  • M75.12 - Complete rotator cuff tear or rupture, not specified as traumatic

  • M75.2 - Rotator cuff tear or rupture, traumatic

  • M75.20 - Unspecified rotator cuff tear or rupture, traumatic

  • M75.21 - Partial rotator cuff tear or rupture, traumatic

  • M75.22 - Complete rotator cuff tear or rupture, traumatic


Rotator Cuff Tendinitis:


Rotator cuff tendinitis, also known as shoulder tendinitis, is a common condition that occurs when the tendons of the rotator cuff become irritated or inflamed. The rotator cuff is a group of muscles and tendons that connect the upper arm bone to the shoulder blade and help to stabilize the shoulder joint.


Rotator cuff tendinitis typically occurs as a result of overuse, repetitive motions, or degenerative changes in the tendon. It is common among athletes who engage in overhead sports, such as baseball, tennis, and swimming, as well as people who engage in repetitive lifting or manual labor.


The symptoms of rotator cuff tendinitis may include pain in the shoulder, especially when lifting or reaching overhead, weakness in the shoulder, and stiffness or limited range of motion. The pain may be more severe at night, making it difficult to sleep on the affected side.


Treatment for rotator cuff tendinitis may include:


  • Rest and ice: Resting the shoulder and applying ice to the affected area can help reduce pain and inflammation.


  • Medications: Over-the-counter pain relievers such as ibuprofen or acetaminophen may help relieve pain and reduce inflammation.


  • Physical therapy: Specific exercises to strengthen the rotator cuff muscles and improve range of motion can help alleviate symptoms and prevent further injury.


  • Steroid injections: Corticosteroid injections into the shoulder joint can help reduce pain and inflammation.


In most cases, conservative treatments are effective in relieving symptoms of rotator cuff tendinitis. However, if symptoms persist despite conservative treatments, surgery may be necessary to repair or remove the damaged tendon.


The ICD-10 codes for rotator cuff tendinitis are:

  • M75.3 - Tendinitis of the rotator cuff

  • M75.30 - Unspecified rotator cuff tear or rupture, not specified as traumatic

  • M75.31 - Supraspinatus tendinitis

  • M75.32 - Infraspinatus tendinitis

  • M75.33 - Subscapularis tendinitis

  • M75.34 - Other rotator cuff tendinitis


Shoulder rehabilitation and treatment is very common within most physical therapy practices. Proper coding and billing for many of the most common diagnosis associated with shoulder pain is essential in order to maintain a lucrative business. PatientStudio makes the coding process simple and streamlined to limit denials from insurance, check out how by scheduling a demo with our team today.


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