Is M75.111 a billable ICD-10-CM code?

Yes. M75.111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M75.111 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 M75.111?

M75.111 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 M75.111 (M75.1) and apply to it just the same.

M75.111

M75.111 — Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic

Billable / specific codeICD-10-CMright

M75.111 is a billable, specific ICD-10-CM code for incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic. It is valid for submission on a claim.

Excludes1 inherited from the categories above M75.111

These are not written on M75.111, but they bind it: a note on a category applies to every code beneath it. Billing M75.111 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 M75.111

Also inherited, and the opposite of Excludes1: these conditions are not part of M75.111, but a patient can have both, so you may code both.

Written on M75 — Shoulder lesions

shoulder-hand syndrome (M89.0-)

Risk adjustment

M75.111 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

M75.111 is named in 14 Medicare coverage policies — 7 listing it as supporting medical necessity, and 7 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
A58883Billing 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

Code history

M75.111 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share M75.11. If M75.111 is not quite right, the correct code is usually one of these.

Questions about M75.111

Is M75.111 a billable ICD-10-CM code?: Yes. M75.111 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M75.111 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 M75.111?: M75.111 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 M75.111 (M75.1) and apply to it just the same.