ICD Code M75.101

ICD code M75.101 is used to identify an unspecified rotator cuff tear or rupture in the right shoulder, where the cause of the tear or rupture is not specified as being due to trauma. This code is utilized in medical billing and documentation to accurately describe the condition for treatment and insurance purposes.

1. Presence of Shoulder Pain: The patient reports persistent or intermittent pain in the right shoulder, which may worsen with specific movements or activities.

2. Limited Range of Motion: The patient experiences a noticeable reduction in the ability to move the right shoulder, particularly during activities that involve lifting the arm or reaching overhead.

3. Weakness in the Shoulder: The patient exhibits weakness in the right shoulder, which may be evident during physical examination or when performing tasks that require shoulder strength.

4. History of Shoulder Issues: The patient has a history of shoulder problems, such as previous injuries, overuse, or degenerative conditions, that could contribute to a rotator cuff tear or rupture.

5. Physical Examination Findings: Clinical examination reveals tenderness, swelling, or deformity in the right shoulder area, along with positive results on specific tests designed to assess rotator cuff integrity.

6. Imaging Results: Diagnostic imaging, such as an MRI or ultrasound, indicates the presence of a tear or rupture in the rotator cuff of the right shoulder, without clear evidence of trauma.

7. Exclusion of Traumatic Causes: The tear or rupture is determined to be non-traumatic, meaning it did not result from a specific injury or accident, but rather from degenerative changes or other non-traumatic factors.

8. Confirmation of Unspecified Nature: The exact nature or cause of the rotator cuff tear or rupture is not specified, and it is classified as unspecified due to the lack of detailed information or inability to determine the precise cause.

For the ICD code M75.101, which pertains to an unspecified rotator cuff tear or rupture of the right shoulder, not specified as traumatic, the relevant CPT codes that may be applicable include:

1. 23410 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute.

2. 23412 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic.

3. 29827 - Arthroscopy, shoulder, surgical; with rotator cuff repair.

4. 29828 - Arthroscopy, shoulder, surgical; biceps tenodesis.

These CPT codes are typically used for procedures related to the repair of rotator cuff tears or ruptures. It is important for healthcare providers to verify the specific details of the procedure performed to ensure accurate coding and billing.

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