Is M75.11 a billable ICD-10-CM code?

No. M75.11 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does M75.11 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other soft tissue disorders (M70-M79).

What cannot be coded together with M75.11?

M75.11 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M75.11 (M75.1) and apply to it just the same.

M75.11

M75.11 — Incomplete rotator cuff tear or rupture not specified as traumatic

Non-billable headerICD-10-CM

M75.11 is a non-billable header ICD-10-CM code for incomplete 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 inherited from the categories above M75.11

These are not written on M75.11, but they bind it: a note on a category applies to every code beneath it. Billing M75.11 with anything listed here is a denial.

Written on M75.1 — Rotator cuff tear or rupture, not specified as traumatic

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

Excludes2 inherited from the categories above M75.11

Also inherited, and the opposite of Excludes1: these conditions are not part of M75.11, but a patient can have both, so you may code both.

Written on M75 — Shoulder lesions

shoulder-hand syndrome (M89.0-)

Risk adjustment

M75.11 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.

Code history

M75.11 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead M75.11

3 child codes. Green means billable.

Related codes at this level

Codes that share M75.1. If M75.11 is not quite right, the correct code is usually one of these.

Questions about M75.11

Is M75.11 a billable ICD-10-CM code?: No. M75.11 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does M75.11 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other soft tissue disorders (M70-M79).
What cannot be coded together with M75.11?: M75.11 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M75.11 (M75.1) and apply to it just the same.