M75.80

Covers soft-tissue shoulder lesions that don't map to a more specific M75 subcategory and where laterality is undocumented or unknown.

Verified May 8, 2026 · 5 sources ↓

Status: Billable
Chapter: 13
Related CPT: 10
Region: Shoulder

Drawn from CDCICD10DataAAPCIcdlist

Documentation tips

What should appear in the chart to support M75.80.

Source · Editorial brief grounded in 5 cited references ↓

Specify laterality by name (right or left) in every encounter note — this moves the code from M75.80 to the laterality-specific M75.81 or M75.82 and reduces audit risk.
Name the lesion type explicitly: 'supraspinatus tendinitis,' 'painful arc syndrome,' or 'shoulder tendinosis' ties documentation to the M75.8x branch rather than the vague M75.9x category.
Record imaging findings that support a soft-tissue lesion diagnosis — MRI signal changes, ultrasound tendon thickening, or radiographic calcification help establish medical necessity.
Document prior conservative care (injections, physical therapy, NSAIDs) when the encounter involves procedural intervention; this supports medical necessity for surgical or advanced diagnostic codes billed alongside M75.80.
If a more specific M75 subcode applies (e.g., M75.3x for calcific tendinitis), use it — M75.80 should never substitute for a code the Tabular List offers at greater specificity.

Related CPT procedures

Procedure codes commonly billed with M75.80. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

29827 $976.31

Arthroscopic surgical repair of the rotator cuff, performed entirely through the shoulder joint via endoscopic technique.

29826 $147.63

Arthroscopic shoulder surgery to decompress the subacromial space, including partial reshaping of the acromion and release of the coracoacromial ligament when performed. Add-on code — always listed in addition to a primary shoulder arthroscopy code.

29823 $558.80

Arthroscopic surgical debridement of the shoulder involving three or more discrete anatomic structures.

29824 $638.96

Arthroscopic resection of the distal clavicle including its articular surface, performed at the acromioclavicular joint (the Mumford procedure).

73221 $205.08

MRI of any upper extremity joint — shoulder, elbow, or wrist — performed without contrast material.

73222 $312.63

MRI of an upper extremity joint performed with contrast material — covers shoulder, elbow, wrist, or hand joints.

20610 $68.81

Aspiration and/or injection of a major joint or bursa (shoulder, hip, knee, or subacromial bursa) performed without ultrasound guidance.

97110 $29.06

Therapeutic exercise billed per 15-minute unit, targeting strength, endurance, range of motion, or flexibility with direct one-on-one patient contact.

99213 $95.19

Established patient office or outpatient visit requiring 20–29 minutes of total time or low-complexity medical decision-making.

73223 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M75.80 and adjacent codes.

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

Using M75.80 when laterality is documented: the physician note says 'right shoulder' but the coder defaults to the unspecified code — always check the note for side before assigning M75.80.
Confusing M75.80 (other shoulder lesions, unspecified side) with M75.90 (shoulder lesion, unspecified, unspecified side) — M75.80 implies a known lesion type in the 'other' category; M75.90 is for entirely undefined shoulder lesions.
Assigning M75.80 when a specific M75 subcategory fits: impingement (M75.4x), bursitis (M75.5x), and rotator cuff conditions (M75.1x) each have their own codes — M75.80 is not a default shoulder code.
Coding painful arc syndrome or supraspinatus tendinitis to a pain code (M25.51x) instead of M75.80 when the provider has documented the lesion type; the lesion code is more specific and preferred.
Billing M75.80 with an S-code for an acute traumatic shoulder injury when the condition is actually chronic or degenerative — M-codes and S-codes have distinct acute vs. chronic intent that must match documentation.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M75.80 is the catch-all for shoulder lesions that fall under the M75.8 'other' branch but lack documented laterality. Use it only after confirming the condition cannot be classified under a more specific M75 code — rotator cuff pathology (M75.1x), calcific tendinitis (M75.3x), impingement syndrome (M75.4x), or bursitis (M75.5x). If the shoulder side is documented, move immediately to M75.81 (right) or M75.82 (left).

Approximate synonyms in the ICD-10-CM index include painful arc syndrome, shoulder tendinitis, supraspinatus tendinitis, and tendinitis of the shoulder. If your physician documents one of these terms without a more precise structural diagnosis and without naming a side, M75.80 is the appropriate landing code — not M75.9x (shoulder lesion, unspecified), which is reserved for entirely uncharacterized lesions. The distinction between M75.8x and M75.9x is specificity of lesion type, not laterality.

For MS-DRG grouping, M75.80 falls under DRG 557 (Tendonitis, myositis and bursitis with MCC) or 558 (without MCC). An Excludes 2 note at the M75 category level means you can report shoulder-hand syndrome (M89.0-) alongside M75.80 when both conditions are independently documented.

Sibling codes

Other billable codes under M75.8 (laterality / anatomic variants).

M75.82

Other shoulder lesions, left shoulder

M75.81

Other shoulder lesions, right shoulder

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01When is M75.80 appropriate versus M75.81 or M75.82?

Use M75.80 only when the provider's documentation does not specify right or left shoulder. If any laterality is documented, assign M75.81 (right) or M75.82 (left) instead.

02What is the difference between M75.80 and M75.90?

M75.80 indicates a shoulder lesion of a known 'other' type (e.g., painful arc, tendinitis not elsewhere classified) on an unspecified side. M75.90 is for a shoulder lesion that is entirely uncharacterized — both the type and side are unknown. Use M75.80 when the lesion type is identified but side is missing.

03Can I use M75.80 for supraspinatus tendinitis?

Yes — supraspinatus tendinitis is listed as an approximate synonym for the M75.8x category. Assign M75.80 if the side is undocumented; M75.81 or M75.82 if laterality is stated.

04Can M75.80 be reported with a shoulder-hand syndrome code (M89.0-)?

Yes. An Excludes 2 note at the M75 category level means shoulder-hand syndrome is not included in M75 but may be coded together when both conditions are independently documented.

05Which DRGs does M75.80 group into for inpatient claims?

Under MS-DRG v43.0, M75.80 groups to DRG 557 (Tendonitis, myositis and bursitis with MCC) or DRG 558 (without MCC), depending on the presence of a major complication or comorbidity.

06Should I use M75.80 for a traumatic shoulder injury?

No. M75.8x codes are for chronic or non-traumatic soft-tissue shoulder lesions. Acute traumatic injuries belong in the S40–S49 range with appropriate 7th-character extensions (A, D, or S). Use M-codes only when the condition is degenerative or not specified as traumatic.

07Is M75.80 valid for FY2026 claims?

Yes. The code has been unchanged since its introduction in FY2016 and remains valid for dates of service on or after October 1, 2025 under the FY2026 ICD-10-CM code set.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira captures the affected shoulder side, lesion type or clinical syndrome name (e.g., painful arc, supraspinatus tendinitis), pertinent imaging results, and history of prior conservative treatment. This prevents laterality downcoding to M75.80 when M75.81 or M75.82 is warranted, and blocks erroneous assignment of a vague M75.9x code when the lesion type is actually documented.

See how Mira captures M75.80 documentation