ICD Code M25.519

ICD code M25.519 is used to identify and document a condition where a patient is experiencing pain in an unspecified shoulder. This code is part of the International Classification of Diseases, 10th Revision (ICD-10), which is used by healthcare providers to standardize the diagnosis of medical conditions for billing and record-keeping purposes. The use of "unspecified" indicates that the documentation does not specify whether the pain is in the left or right shoulder.

1. Presence of Shoulder Pain: The patient reports experiencing pain in the shoulder region without specifying which shoulder is affected.

2. Absence of Specific Diagnosis: The pain is not attributed to a specific underlying condition or injury, such as a fracture, dislocation, or arthritis, after thorough evaluation.

3. Lack of Laterality: The pain is not localized to either the left or right shoulder, or the documentation does not specify which shoulder is affected.

4. Exclusion of Other Conditions: Other potential causes of shoulder pain, such as rotator cuff injuries, bursitis, or tendonitis, have been ruled out through clinical assessment and diagnostic testing.

5. Chronic or Acute Presentation: The pain can be either acute or chronic, but it remains unspecified in terms of duration or onset.

6. Impact on Functionality: The shoulder pain may interfere with the patient's ability to perform daily activities, but the specific impact is not detailed.

7. Non-Specific Symptoms: The patient may exhibit general symptoms associated with shoulder pain, such as stiffness or limited range of motion, but these are not linked to a specific condition.

8. Documentation Requirements: The healthcare provider has documented the presence of shoulder pain without additional details that would allow for a more specific ICD code assignment.

For the ICD code M25.519, which indicates pain in an unspecified 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. 23700 - Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded).

7. 97035 - Application of a modality to 1 or more areas; ultrasound, each 15 minutes.

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 therapies that may be used to address shoulder pain associated with ICD code M25.519. It is important for healthcare providers to select the appropriate CPT code based on the specific treatment provided to the patient.

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