Understanding diagnosis codes is crucial in healthcare for accurate record-keeping, billing, and treatment planning. For those experiencing pain in the right shoulder, the ICD-10-CM code M25.511 is specifically designated. This article will delve into the details of this diagnosis code, providing a comprehensive overview for anyone needing to understand or utilize it.
ICD-10-CM code M25.511 is a billable/specific code, meaning it is precise enough to be used for reimbursement purposes. Officially implemented in the American ICD-10-CM system on October 1, 2015, and updated annually, the 2025 edition remains consistent with previous years, effective from October 1, 2024. It’s important to note that while M25.511 is specific to the American ICD-10-CM, international versions of ICD-10 may have variations.
To ensure accurate coding, it’s helpful to understand the synonymous terms associated with M25.511. These approximate synonyms can guide you to the correct code when dealing with various clinical documentations. For M25.511, these include:
- 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
These synonyms highlight that M25.511 encompasses pain originating from various structures within the right shoulder area, including different joints.
Within the broader ICD-10-CM classification, M25.511 Pain in right shoulder falls under the category of M25.5 Pain in joint and the more general M25 Disorders of joint. It is important to differentiate M25.511 from related codes such as:
- M25.512: Pain in left shoulder
- M25.519: Pain in unspecified shoulder
These distinctions are vital for accurate diagnosis coding and subsequent medical billing. Using the correct specific code like M25.511 ensures clarity and avoids ambiguity in medical records and claims.
In conclusion, ICD-10-CM diagnosis code M25.511 is the designated code for documenting pain in the right shoulder. Its specificity and billable status make it a key component in medical coding and reimbursement processes. Understanding its synonyms and placement within the ICD-10-CM system is essential for healthcare professionals and anyone involved in medical documentation.
