M75.81

A right shoulder soft-tissue condition that does not fit any more specific M75 category — including lesions such as SLAP tears, partial rotator cuff tears (non-traumatic or degenerative), and other structural shoulder pathology confined to the right side.

Verified May 8, 2026 · 5 sources ↓

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

Drawn from CDCICD10DataAAPCIcdcodesUnboundmedicine

Documentation tips

What should appear in the chart to support M75.81.

Source · Editorial brief grounded in 5 cited references ↓

Explicitly document 'right shoulder' by name — do not rely on laterality inferred from operative site or imaging header alone.
Specify the lesion type (e.g., SLAP tear, partial rotator cuff tear, labral lesion) and characterize it as chronic, degenerative, or non-acute to support an M-code over an S-code.
Record MRI or arthroscopic findings that confirm the specific structural lesion — note tear grade, location (e.g., superior labrum, greater tuberosity), and whether the finding is new or chronic.
Document conservative care history (physical therapy, injections, NSAIDs) if the encounter involves surgical planning, as payers often require evidence of prior treatment.
If a more specific M75 code exists for the documented condition (e.g., M75.41 for impingement, M75.51 for bursitis), use that code — M75.81 is appropriate only when no specific subcategory fits.

Related CPT procedures

Procedure codes commonly billed with M75.81. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

29807 $951.93

Arthroscopic surgical repair of a superior labrum anterior and posterior (SLAP) lesion of the shoulder joint.

29806 $972.97

Arthroscopic surgical repair or tightening of the shoulder joint capsule to correct instability or recurrent dislocation.

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.

29819 $550.11

Arthroscopic shoulder surgery for removal of loose or foreign bodies from the joint

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.

23430 $696.41

Surgical tenodesis of the long head of the biceps tendon, anchoring it to the proximal humerus after debridement of the damaged tissue.

23412 $791.60

Open surgical repair of a chronic rotator cuff tear — one or more tendon components, with the tendon secured into bone via suture through drilled holes or anchors.

Common coding pitfalls

The recurring mistakes coders make with M75.81 and adjacent codes.

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

Using M75.81 when a more specific M75 right shoulder code applies — always rule out M75.11 (rotator cuff syndrome), M75.21 (bicipital tendinitis), M75.31 (calcific tendinitis), M75.41 (impingement), and M75.51 (bursitis) before defaulting here.
Assigning M75.81 for an acute traumatic right shoulder lesion — if the tear or lesion resulted from a specific injury event, evaluate S-codes (e.g., S43.-, S46.-) with the appropriate 7th-character encounter extension (A, D, or S).
Dropping to M75.80 (unspecified shoulder) when the provider has clearly documented 'right' — laterality is documented in the record, so unspecified codes are not acceptable and will trigger specificity edits.
Conflating M75.81 with M75.91 (shoulder lesion, unspecified, right shoulder) — M75.81 implies a defined 'other' lesion type; M75.91 is for encounters where the lesion type itself is unspecified, not just uncategorized.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M75.81 is the catch-all billable code for right shoulder lesions that fall under M75.8 ('Other shoulder lesions') — meaning the condition has been documented with right-side laterality but doesn't map to a more specific M75 subcategory like rotator cuff syndrome (M75.1x), bicipital tendinitis (M75.2), calcific tendinitis (M75.3), impingement syndrome (M75.41), or subacromial bursitis (M75.51). Common clinical scenarios include SLAP tears documented as chronic or degenerative in origin, partial-thickness rotator cuff tears without clear traumatic mechanism, and superior labrum lesions. If the injury is acute and traumatic, evaluate S-codes first.

The code groups into MS-DRG 557 (Tendonitis, myositis and bursitis with MCC) and 558 (without MCC), so payers expect supporting documentation that establishes a defined right shoulder soft-tissue lesion. M75.81 should not be used as a default when a more specific M75 code exists — always work through the M75 subcategory hierarchy before landing here.

If shoulder-hand syndrome is present, exclude it separately under M89.0- per the Excludes2 note on the parent category M75. Bilateral tendonitis of the shoulders is listed as an approximate synonym under the parent M75 grouping, but for bilateral conditions, code each side separately (M75.81 + M75.82) rather than relying on a single unspecified code.

Sibling codes

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

M75.80

Other shoulder lesions, unspecified shoulder

M75.82

Other shoulder lesions, left shoulder

Frequently asked questions

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

01When should I use M75.81 instead of M75.11 for a right rotator cuff problem?

Use M75.11 (rotator cuff syndrome, right shoulder) for rotator cuff syndrome or incomplete tear of the right rotator cuff. Use M75.81 only if the documented condition — such as a SLAP tear or labral lesion — does not fit M75.11 or any other specific M75 subcategory.

02Can M75.81 be used for a right SLAP tear?

Yes. A SLAP (superior labrum anterior-posterior) lesion is an accepted clinical condition mapped to M75.81 when documented as chronic or degenerative. If the SLAP tear is acute-traumatic, consider S43.- codes with the appropriate 7th-character extension instead.

03Should I code bilateral shoulder lesions with M75.81 alone?

No. Code each side separately: M75.81 for the right shoulder and M75.82 for the left. Do not use M75.80 (unspecified) as a bilateral stand-in — it denotes unknown laterality, not bilateral involvement.

04Does the Excludes2 note on M75 affect how I use M75.81?

The Excludes2 note excludes shoulder-hand syndrome (M89.0-), meaning that condition is coded separately if also present. It does not restrict the use of M75.81 for other shoulder lesion types — you may report both M75.81 and an M89.0- code on the same claim if both conditions exist.

05What DRG does M75.81 typically group to for inpatient claims?

M75.81 groups to MS-DRG 557 (Tendonitis, myositis and bursitis with MCC) or MS-DRG 558 (without MCC) under MS-DRG v43.0. Ensure documentation supports the presence or absence of a major complication or comorbidity to land in the correct DRG.

06Is M75.81 appropriate when the physician documents 'right shoulder tendinitis' without specifying a tendon?

Right shoulder tendinitis is listed as an approximate synonym under the M75.8 grouping, so M75.81 is defensible if no specific tendon is named and no more precise M75 code applies. However, if the clinician identifies calcific tendinitis (M75.31) or bicipital tendinitis (M75.21), use those codes instead.

Sources & references

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

Mira AI Scribe

Mira AI Scribe captures the right-side laterality, lesion characterization (SLAP, partial tear, labral pathology), chronicity or degenerative nature, and MRI or arthroscopic findings that distinguish this from a traumatic injury. That documentation prevents downcoding to unspecified M75.80 or M75.91, supports MS-DRG assignment in the tendonitis/bursitis grouping, and blocks payer challenges that arise when laterality or lesion type is missing from the record.

See how Mira captures M75.81 documentation