Shoulder Pain ICD 9 & ICD 10 code – 719.41 , M25.51

Sep 20, 2016 | Medical billing basics

Shoulder Pain ICD 9

ICD-9-CM Diagnosis Code 719.41.

Pain in joint, shoulder region.

Short description: Joint pain-shlder.

ICD-9-CM 719.41 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 719.41 should only be used for claims with a date of service on or before September 30, 2015.

719.4 – Arthralgia
719 Excludes: jaw (524.60-524.69)
710-719 Excludes: disorders of spine (720.0-724.9)

Use additional external cause code, if applicable, to identify the cause of the musculoskeletal condition

DISEASES OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE (710-739)
Use additional external cause code, if applicable, to identify the cause of the musculoskeletal condition

Code(s)   Description

710.0 – 719.99     ARTHROPATHIES AND RELATED DISORDERS (710-719)
720.0 – 724.9     DORSOPATHIES (720-724)
725 – 729.99     RHEUMATISM, EXCLUDING THE BACK (725-729)
730.00 – 739.9     OSTEOPATHIES, CHONDROPATHIES, AND ACQUIRED MUSCULOSKELETAL DEFORMITIES (730-739)

ICD 10 Code for shoulder pain

M25.511 – Pain in right shoulder
M25.512 – Pain in left shoulder
M25.519 – Pain in unspecified shoulder
M25.51 Pain in shoulder

719.41 Pain in joint, shoulder region  Can be replaced by the below codes.
M25.511 Pain in right shoulder
M25.512 Pain in left shoulder
M25.519 Pain in unspecified shoulder
Coding Example for Frozen right shoulder
• 52 year old female with right shoulder pain; “6” on 1‐10 scale.
• Significant decreased ROM noted.
• Difficulty with ADLs including carrying briefcase, driving, dressing and cooking noted.
• Patient states sleep is also being affected
• Disabilities of the Arm, Shoulder & Hand (Dash) Score = 72%
• Active and passive range of motion to right shoulder significantly decreased.
• Capsular Pattern noted
• Firm end feel
• Neurological exam normal
• History of type II diabetes
ICD‐9‐CM Diagnosis Codes vs ICD‐10‐CM Diagnosis Codes
726.0 Adhesive capsulitis of shoulder  M75.01 Adhesive capsulitis of right shoulder
719.41 Pain in Joint, Shoulder Region M25.511 Pain in Right Shoulder
719.51 Stiffness of joint, not elsewhere classified, shoulder region M25.611 Stiffness of right shoulder, not elsewhere classified
250.90 Diabetes with unspecified complication, type II or unspecified type, not stated as uncontrolled E11.8 Type 2 diabetes mellitus with unspecified
complications
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