ICD-10 DIAGNOSIS CODE
Billable: Yes
Code Specificity: High
Code Set: ICD-10-CM 2026
M25.511 represents pain in the right shoulder. It is assigned when a healthcare provider documents right shoulder pain without identifying a more specific underlying condition. The right shoulder pain ICD-10 code is selected based on the provider's documentation and M25.511 should only be used when no more specific ICD-10-CM code applies.
Diseases of the musculoskeletal system and connective tissue
Other joint disorders
Other joint disorders, not elsewhere classified
Pain in right shoulder (this code)
Note: Right clavicle pain ICD-10 may require a different diagnosis code if the provider identifies the clavicle as the primary site of pain or documents a specific injury. Likewise, bilateral shoulder pain ICD-10 coding typically requires separate diagnosis codes for the right and left shoulders when both are documented.
Common CPT codes that may be billed with M25.511 when medically necessary include:
M25.511 should not be reported when documentation supports a more specific diagnosis affecting the right shoulder.
Examples include:
Note: If the provider identifies a specific injury or musculoskeletal condition, the corresponding ICD-10-CM diagnosis code should be reported instead of the shoulder pain ICD-10 symptom code.
Right shoulder pain is a common musculoskeletal complaint that may result from overuse, injury, inflammation, arthritis or degenerative joint disease. Symptoms can range from mild discomfort to significant pain that limits daily activities and shoulder movement.
The right shoulder pain ICD-10 code M25.511 is commonly used when right shoulder pain is documented but the underlying cause has not yet been confirmed.
Patients with right shoulder pain may experience:
Note: The ICD-10 code for shoulder pain depends on the documented location and underlying diagnosis. When a specific condition such as a rotator cuff tear or adhesive capsulitis is identified, a more specific ICD-10-CM code should be assigned instead of M25.511.
The M25.511 diagnosis code represents pain in the right shoulder. It is assigned when right shoulder pain is documented but no more specific shoulder condition has been confirmed.
The ICD-10 code for shoulder pain depends on the affected shoulder. M25.511 is used for the right shoulder, M25.512 for the left shoulder and M25.519 for an unspecified shoulder.
Right clavicle pain ICD-10 coding depends on the documented diagnosis. If the pain is isolated to the clavicle or caused by a specific clavicular injury, a different ICD-10-CM code may be more appropriate than M25.511.
There is no single bilateral shoulder pain ICD-10 code. Providers generally report M25.511 for the right shoulder and M25.512 for the left shoulder when pain affects both shoulders.
Documentation should include a detailed history of the patient's shoulder pain, physical examination findings, any imaging results, and the treatment plan. Specificity regarding the pain's onset, duration, and characteristics is essential.
