ICD Code M62.119

ICD code M62119 is used to classify a condition involving the rupture of a muscle in the shoulder area that is not caused by trauma. This code is specifically applied when the rupture occurs in an unspecified shoulder, meaning it does not specify whether it is the left or right shoulder. The term "nontraumatic" indicates that the rupture is not the result of an external injury or accident but may be due to other factors such as overuse, degeneration, or a spontaneous tear. This code helps healthcare providers accurately document and communicate the diagnosis for billing and treatment purposes.

When to use the ICD code M62119, which pertains to other rupture of muscle (nontraumatic), unspecified shoulder, the following diagnostic criteria and symptoms should be considered:

1. Patient History
- No recent traumatic injury or incident reported.
- History of repetitive overhead activities or strain on the shoulder.

2. Symptoms
- Sudden onset of shoulder pain without a clear traumatic event.
- Weakness in the shoulder or arm, particularly during movement.
- Limited range of motion in the shoulder joint.
- Swelling or tenderness in the shoulder area.

3. Physical Examination Findings
- Palpable tenderness over the shoulder muscles.
- Signs of muscle atrophy or weakness upon examination.
- Positive findings on specific shoulder tests indicating muscle rupture.

4. Imaging Studies
- MRI or ultrasound findings indicating a rupture of muscle tissue in the shoulder without evidence of trauma.
- Absence of bony abnormalities or fractures in imaging studies.

5. Exclusion of Other Conditions
- Rule out other potential causes of shoulder pain, such as rotator cuff tears, tendonitis, or bursitis.
- Ensure that the symptoms are not attributable to systemic conditions or referred pain from other anatomical areas.

6. Duration of Symptoms
- Symptoms persisting for a significant duration, typically beyond acute injury timelines, indicating a nontraumatic origin.

7. Response to Conservative Treatment
- Lack of improvement with conservative management strategies, such as rest, ice, and physical therapy.

By adhering to these diagnostic criteria and symptoms, healthcare providers can accurately determine the appropriateness of using the ICD code M62119 for billing and documentation purposes.

For the ICD code M62.119, which pertains to "Other rupture of muscle (nontraumatic), unspecified shoulder," the relevant CPT codes that may be applicable for treatment could 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 examples of procedures that might be performed to address issues related to muscle ruptures in the shoulder area. It is important for healthcare providers to verify the specific clinical scenario and documentation to ensure accurate coding and billing.

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