M66.811
M66.811 — Spontaneous rupture of other tendons, right shoulder
Billable / specific codeICD-10-CMright
M66.811 is a billable, specific ICD-10-CM code for spontaneous rupture of other tendons, right shoulder. It is valid for submission on a claim.
Risk adjustment
M66.811 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
M66.811 is named in 12 Medicare coverage policies — 6 listing it as supporting medical necessity, and 6 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
- A59434Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
Related codes at this level
Codes that share M66.81. If M66.811 is not quite right, the correct code is usually one of these.
Questions about M66.811
- Is M66.811 a billable ICD-10-CM code?
- Yes. M66.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does M66.811 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Disorders of synovium and tendon (M65-M67).