ICD Code M62.112

ICD code M62112 is used to classify a medical diagnosis where there is a rupture of a muscle in the left shoulder that is not caused by trauma. This code helps healthcare providers document and communicate the specific nature of the muscle injury, which is essential for treatment planning, billing, and insurance purposes. The "nontraumatic" aspect indicates that the rupture occurred without an external force or injury, such as a fall or accident, and may be due to factors like overuse or a degenerative condition.

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

1. Patient History:

- Documented history of nontraumatic muscle injury or strain in the left shoulder region.

- Previous episodes of shoulder pain or discomfort that may indicate chronic issues.

2. Symptoms:

- Sudden onset of pain in the left shoulder without a clear traumatic event.

- Swelling or tenderness in the left shoulder area.

- Limited range of motion or difficulty in performing overhead activities.

- Muscle weakness in the left shoulder, particularly during specific movements.

3. Physical Examination Findings:

- Palpable tenderness over the affected muscle group in the left shoulder.

- Signs of muscle atrophy or weakness upon examination.

- Positive findings on specific tests for muscle integrity or function.

4. Imaging and Diagnostic Tests:

- MRI or ultrasound findings indicating a rupture or significant tear of the muscle in the left shoulder.

- Exclusion of other potential causes of shoulder pain through imaging studies.

5. Treatment Response:

- Lack of improvement with conservative management (e.g., rest, physical therapy) after a specified duration.

- Need for further intervention or surgical evaluation due to persistent symptoms.

6. Documentation:

- Comprehensive documentation of all findings, symptoms, and treatment attempts in the patient's medical record to support the diagnosis.

Using the ICD code is appropriate when these criteria and symptoms are met, ensuring accurate coding and billing for the condition.

For the ICD code M62.112, which pertains to a nontraumatic rupture of muscle in the left shoulder, the relevant CPT codes that may be applicable for treatment include:

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

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

3. CPT 23420 - Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty).

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

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

These CPT codes are typically used for procedures related to the repair or reconstruction of muscle or tendon injuries in the shoulder area. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical details of the case.

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