ICD Code M60.811

ICD code M60.811 is used to classify and document the diagnosis of "Other myositis, right shoulder." Myositis refers to inflammation of the muscles, and this specific code indicates that the inflammation is occurring in the muscles of the right shoulder. The term "other" suggests that the myositis does not fall under more specific categories of muscle inflammation, such as those caused by infections or autoimmune diseases. This code is crucial for healthcare providers to accurately record the condition for treatment planning, billing, and statistical purposes.

When to use the ICD code for "Other myositis, right shoulder":

1. Presence of Muscle Inflammation: Documented evidence of inflammation in the muscle tissue of the right shoulder.

2. Symptoms of Pain: Patient reports localized pain in the right shoulder, which may be exacerbated by movement or pressure.

3. Muscle Weakness: Observable or reported weakness in the muscles surrounding the right shoulder, affecting range of motion.

4. Swelling or Edema: Physical examination reveals swelling in the right shoulder area, indicating possible inflammation.

5. Limited Range of Motion: Assessment shows a reduced ability to move the right shoulder joint through its full range of motion.

6. Fatigue: Patient experiences generalized fatigue that may accompany the localized symptoms.

7. Diagnostic Imaging Findings: Imaging studies (e.g., MRI, ultrasound) indicate signs of myositis or other related abnormalities in the right shoulder muscles.

8. Exclusion of Other Conditions: Other potential causes of shoulder pain and inflammation (e.g., rotator cuff injury, bursitis) have been ruled out through clinical evaluation and diagnostic testing.

9. Chronic Symptoms: Symptoms have persisted for an extended period, typically more than a few weeks, indicating a chronic condition.

10. Response to Treatment: Patient's symptoms do not improve with standard conservative treatments, suggesting a specific underlying condition such as myositis.

These criteria should be carefully evaluated to determine the appropriate use of the ICD code in clinical documentation and billing processes.

For the ICD code M60.811, which pertains to "Other myositis, right shoulder," the relevant CPT codes that may be applicable for treatment include:

1. 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia").

2. 20551 - Injection(s); single tendon origin/insertion.

3. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa), without ultrasound guidance.

4. 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.

5. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (each 15 minutes).

6. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

7. 99213 - Established patient office or other outpatient visit, typically 15 minutes.

These CPT codes are examples of procedures and services that might be used in the treatment of conditions related to the ICD code M60.811. It's important for healthcare providers to select the most appropriate CPT code based on the specific treatment plan and services provided to the patient.

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