ICD Code M65.911

ICD code M65.911 is used to classify a medical diagnosis of unspecified synovitis and tenosynovitis affecting the right shoulder. Synovitis refers to the inflammation of the synovial membrane, which lines joints and tendons, while tenosynovitis involves inflammation of the sheath surrounding a tendon. This code is used when the specific type of synovitis or tenosynovitis is not detailed, but the condition is confirmed to be present in the right shoulder. Proper coding of this condition is crucial for accurate billing and reimbursement processes in healthcare settings.

When considering the use of the ICD code M65911 for unspecified synovitis and tenosynovitis of the right shoulder, the following diagnostic criteria and symptoms should be evaluated:

1. Joint Pain: Patient reports pain localized to the right shoulder joint.

2. Swelling: Observable swelling or inflammation around the right shoulder area.

3. Limited Range of Motion: Difficulty or discomfort when attempting to move the right shoulder.

4. Tenderness: Palpation of the right shoulder elicits tenderness or discomfort.

5. History of Injury: Recent history of trauma or overuse of the right shoulder that may contribute to inflammation.

6. Joint Stiffness: Stiffness in the right shoulder, particularly after periods of inactivity.

7. Imaging Findings: MRI or ultrasound results indicating synovitis or tenosynovitis without a specific underlying cause.

8. Exclusion of Other Conditions: Other potential causes of shoulder pain and inflammation have been ruled out, such as fractures, arthritis, or infections.

9. Duration of Symptoms: Symptoms have persisted for a certain duration, typically more than a few weeks, indicating a chronic condition.

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

For the ICD code M65.911, which pertains to unspecified synovitis and tenosynovitis of the right 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. 73030 - Radiologic examination, shoulder; complete, minimum of two views.

4. 73221 - Magnetic resonance (e.g., proton) imaging, any joint of upper extremity; without contrast material.

5. 97035 - Application of a modality to 1 or more areas; ultrasound, each 15 minutes.

6. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (each 15 minutes).

7. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

These CPT codes are commonly used in the management and treatment of conditions related to synovitis and tenosynovitis of the shoulder. It is important for healthcare providers to select the appropriate CPT code based on the specific treatment or procedure performed.

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