Q/A: What Code do I Use for Supraspinatus and Infraspinatus Tendonitis?

May 7th, 2018 - Wyn Staheli, Director of Research
Categories:   Diagnosis Coding   Billing   Chiropractic  
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Question

I am looking for a supraspinatus and infraspinatus tendonitis code but I only see a rotator cuff tear. I am not sure if there is a better one.

Answer

Unfortunately, ICD-10 really doesn't have many options when it comes to tendonitis. According to one doctor, tendonitis is the default radiologist term for inflammation of the tendons which could be either bursitis or tendonitis even though they are not entirely the same thing. It sounds like you were referring to "M75.1- Rotator cuff tear or rupture, not specified as traumatic." However, unless the radiological report specifies a tear, the more appropriate options (based on the ICD-10 index which refers to nontraumatic lesions, the ICD-10 crosswalks, and the recommendations of others) would be one of the following, depending on the clinical record:

  • M75.5- Bursitis of shoulder 
  • M75.8- Other shoulder lesions
  • M75.9- Shoulder lesion, unspecified (note this is unspecific and the other two are typically better choices for most payers)

Some coders have suggested using "M65.81- Other synovitis and tenosynovitis", but based on the index the M75- codes are more applicable. 

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