by Wyn Staheli, Director of Content - innoviHealth
May 7th, 2018 - Reviewed/Updated Jan 28th
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.
About Wyn Staheli, Director of Content - innoviHealth
Wyn Staheli is the Director of Content Research for innovHealth. She has over 30 years of experience in the healthcare industry. With her degree in Management Information Systems (MIS), she has been a programmer for a large insurance carrier as well as a California hospital system. She is also the author and editor of many medical resource books and the founder of InstaCode Institute.
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