M75.1

M75.1: Rotator cuff tear or rupture, not specified as traumatic

Non-billable headerICD-10-CM

M75.1 is a non-billable header ICD-10-CM code for rotator cuff tear or rupture, not specified as traumatic. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

tear of rotator cuff, traumatic (S46.01-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Rotator cuff syndrome
Supraspinatus tear or rupture, not specified as traumatic
Supraspinatus syndrome

Excludes2 inherited from the categories above M75.1

Not part of this code, but both may be coded when both are present.

Written on M75: Shoulder lesions

shoulder-hand syndrome (M89.0-)

Other codes that can never be billed with M75.1

Their own Excludes1 notes name this code, so the conflict is not listed above.

S43.42Sprain of rotator cuff capsule

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead M75.1

3 child codes. Green means billable.