ICD Code M62.111

ICD code M62.111 is used to classify a condition where there is a rupture of a muscle in the right shoulder that is not caused by trauma. This code is part of the International Classification of Diseases (ICD) system, which is used by healthcare providers to document and categorize medical diagnoses. The "M62" category refers to disorders of muscles, and the specific code "111" indicates that the rupture is nontraumatic and located in the right shoulder. This code helps in the accurate documentation of the patient's condition, facilitating appropriate treatment and billing processes.

When to use the ICD code for "Other rupture of muscle (nontraumatic), right shoulder":

1. Presence of Muscle Rupture: Confirmed diagnosis of a rupture in the muscle tissue of the right shoulder, as evidenced by imaging studies or clinical examination.

2. Non-Traumatic Origin: The rupture must not be the result of a direct traumatic event, such as a fall or impact, but rather due to other factors such as overuse, degeneration, or underlying medical conditions.

3. Symptoms of Pain: Patient reports localized pain in the right shoulder, which may be acute or chronic in nature.

4. Limited Range of Motion: Observed or reported difficulty in moving the right shoulder, indicating a functional impairment.

5. Swelling or Inflammation: Presence of swelling or signs of inflammation in the right shoulder area, which may be assessed through physical examination.

6. Muscle Weakness: Notable weakness in the affected muscle group, impacting the patient's ability to perform daily activities or specific movements.

7. Diagnostic Imaging Findings: Results from MRI, ultrasound, or other imaging modalities that confirm the diagnosis of a muscle rupture without trauma.

8. Exclusion of Other Conditions: Other potential causes of shoulder pain and dysfunction have been ruled out, ensuring that the diagnosis specifically pertains to a non-traumatic muscle rupture.

9. Patient History: Relevant medical history that may contribute to the condition, such as previous shoulder injuries, chronic conditions, or repetitive strain activities.

10. Clinical Assessment: Comprehensive evaluation by a healthcare provider, including physical examination and assessment of symptoms, leading to the conclusion of a non-traumatic muscle rupture.

For the ICD code M62.111, which pertains to "Other rupture of muscle (nontraumatic), right shoulder," the relevant CPT codes that may be applicable for treatment include:

1. 23929 - Unlisted procedure, shoulder.

2. 24341 - Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff).

3. 24342 - Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft.

4. 24343 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute.

5. 24344 - Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic.

These CPT codes are examples of procedures that might be considered based on the specific clinical scenario and physician's assessment. It's important for healthcare providers to verify the most appropriate code based on the specific details of the patient's condition and the procedures performed.

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