M75.01 identifies adhesive capsulitis (frozen shoulder) localized to the right shoulder — a progressive fibrotic contracture of the glenohumeral joint capsule causing global range-of-motion restriction and pain.

Documentation tips

What should appear in the chart to support M75.01.

Source · Editorial brief grounded in 5 cited references ↓

• Explicitly name the affected side ('right shoulder') — 'shoulder' alone forces the unspecified code M75.00 and risks payer downcoding or denial.
• Document the clinical stage or phase if known (freezing, frozen, thawing) and any measurable range-of-motion deficits in degrees to support medical necessity for ongoing therapy.
• Record conservative treatment history (physical therapy duration, corticosteroid injection attempts, NSAIDs) to meet payer prior-authorization criteria for manipulation under anesthesia or hydrodilatation.
• Note relevant comorbidities — particularly diabetes mellitus and thyroid disorders — that are clinically associated with adhesive capsulitis; these support medical necessity and may require additional codes.
• When imaging (X-ray or MRI) has been performed to rule out competing diagnoses (rotator cuff tear, glenohumeral OA), reference the negative or confirmatory findings in the assessment to justify the M75.01 assignment.

Related CPT procedures

Procedure codes commonly billed with M75.01. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

Common coding pitfalls

The recurring mistakes coders make with M75.01 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

• Defaulting to M75.00 (unspecified shoulder) when the note clearly names the right shoulder — always use M75.01 when laterality is documented.
• Coding M75.01 alongside shoulder pain code M25.511 after the diagnosis is established — once adhesive capsulitis is confirmed, the pain code is redundant and is not separately reported.
• Confusing adhesive capsulitis with rotator cuff pathology: M75.01 requires global passive ROM restriction; if only specific planes are limited or the provider documents a cuff tear as the primary finding, a code from M75.1x may be more accurate.
• Applying a 7th-character extension (A, D, S) to M75.01 — M-codes in Chapter 13 do not use encounter-type extensions; the code is reported as-is at every encounter.
• Billing M75.01 for shoulder stiffness following a recent traumatic injury without provider confirmation of adhesive capsulitis — post-traumatic stiffness may warrant M25.61x (stiffness of shoulder) until the diagnosis is clinically established.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

Sibling codes

Other billable codes under M75.0 (laterality / anatomic variants).