ICD Code M25.512

ICD code M25.512 is used to identify and document the diagnosis of pain specifically located in the left shoulder. This code is part of the International Classification of Diseases, 10th Revision (ICD-10), which is utilized by healthcare providers to standardize the reporting of diseases and conditions. The use of this code helps in accurately capturing patient data for billing, treatment planning, and statistical analysis within the healthcare system.

1. Localized Pain: The patient reports experiencing pain specifically in the left shoulder region, without any indication of pain radiating to other areas.

2. Onset and Duration: The pain in the left shoulder has been present for a significant duration, whether acute or chronic, and is impacting the patient's daily activities or quality of life.

3. Exclusion of Other Conditions: Other potential causes of shoulder pain, such as fractures, dislocations, or systemic conditions, have been ruled out through appropriate diagnostic tests and clinical evaluation.

4. Physical Examination Findings: Clinical examination reveals tenderness, discomfort, or pain upon palpation or movement of the left shoulder, confirming the patient's reported symptoms.

5. Imaging and Diagnostic Tests: Imaging studies, such as X-rays, MRIs, or ultrasounds, do not show any structural abnormalities that would account for the pain, supporting a diagnosis of non-specific shoulder pain.

6. Patient History: The patient's medical history does not indicate any previous injuries or surgeries to the left shoulder that could explain the current pain.

7. Impact on Functionality: The pain is significant enough to interfere with the patient's ability to perform routine tasks or occupational duties, necessitating medical attention and documentation.

8. Response to Treatment: The patient may have tried initial conservative treatments, such as rest, ice, or over-the-counter pain medications, with limited or no relief, prompting further medical evaluation.

By meeting these criteria, healthcare providers can accurately document and code the condition using the appropriate ICD code, ensuring proper management and billing processes.

For the ICD code M25.512, which indicates pain in the left shoulder, the relevant CPT codes that may be applicable for treatment include:

1. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); without ultrasound guidance.

2. 20611 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa); with ultrasound guidance, with permanent recording and reporting.

3. 23130 - Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release.

4. 23410 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute.

5. 23412 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic.

6. 29826 - Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release.

7. 29827 - Arthroscopy, shoulder, surgical; with rotator cuff repair.

8. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (each 15 minutes).

9. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

These CPT codes are examples of procedures and services that may be performed to address pain in the left shoulder, as indicated by ICD code M25.512. It is important for healthcare providers to select the appropriate CPT code based on the specific treatment and services provided to the patient.

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