ICD Code M67.311

ICD code M67311 is used to identify a medical condition known as transient synovitis affecting the right shoulder. This condition is characterized by temporary inflammation of the synovial membrane, which is the lining of the joint. It often results in pain, swelling, and limited movement in the affected shoulder. The term "transient" indicates that the condition is temporary and typically resolves on its own or with minimal treatment. This code is utilized by healthcare providers for accurate documentation and billing purposes, ensuring that the specific nature and location of the condition are clearly communicated.

When to use the ICD code for transient synovitis of the right shoulder, consider the following diagnostic criteria and symptoms:

1. Patient History
- Recent history of trauma or injury to the shoulder.
- Previous episodes of joint pain or inflammation.

2. Clinical Symptoms
- Acute onset of shoulder pain, particularly in the right shoulder.
- Limited range of motion in the affected shoulder.
- Swelling or tenderness around the shoulder joint.

3. Physical Examination Findings
- Positive findings on palpation of the shoulder joint.
- Signs of inflammation, such as warmth or redness over the joint.
- Pain exacerbated by movement or weight-bearing activities.

4. Imaging Studies
- MRI or ultrasound showing joint effusion or synovial thickening.
- X-rays ruling out fractures or other bony abnormalities.

5. Laboratory Tests
- Elevated inflammatory markers (e.g., ESR, CRP) indicating inflammation.
- Negative cultures for infectious agents to rule out septic arthritis.

6. Response to Treatment
- Improvement of symptoms with conservative management (e.g., rest, ice, NSAIDs).
- Persistence of symptoms despite initial treatment efforts may warrant further investigation.

7. Exclusion of Other Conditions
- Differential diagnosis should exclude other causes of shoulder pain, such as rotator cuff injuries, bursitis, or arthritis.

These criteria should guide healthcare providers in determining the appropriate use of the ICD code for transient synovitis of the right shoulder.

For the ICD code M67.311, which pertains to transient synovitis 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. 99201-99205 - Office or other outpatient visit for the evaluation and management of a new patient, which may be relevant if the patient is being seen for the first time for this condition.

4. 99211-99215 - Office or other outpatient visit for the evaluation and management of an established patient, which may be relevant for follow-up visits.

5. 97035 - Application of a modality to 1 or more areas; ultrasound, each 15 minutes, which may be used as part of physical therapy treatment.

6. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility, each 15 minutes, which may be part of a rehabilitation program.

These CPT codes are examples of procedures and services that might be used in the management of transient synovitis of the right shoulder, depending on the specific treatment plan and clinical judgment of the healthcare provider. Always ensure that coding is done in accordance with the latest coding guidelines and payer policies.

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments for CPT codes associated with ICD code M67311. Schedule a demo today to see how RevFind can ensure you're receiving the full reimbursement you deserve.