2024 ICD-10-CM Diagnosis Code M25.111
Fistula, right shoulder
- ICD-10-CM Code:
- M25.111
- ICD-10 Code for:
- Fistula, right shoulder
- Is Billable?
- Yes - Valid for Submission
- Chronic Condition Indicator: [1]
- Not chronic
- Code Navigator:
M25.111 is a billable diagnosis code used to specify a medical diagnosis of fistula, right shoulder. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.
Clinical Classification
Clinical Category is Other specified joint disorders
- CCSR Category Code: MUS007
- Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
- Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Convert M25.111 to ICD-9-CM
- ICD-9-CM Code: 719.81 - Joint dis NEC-shlder
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
Patient Education
Fistulas
A fistula is an abnormal connection between two parts inside of the body. Fistulas may develop between different organs, such as between the esophagus and the windpipe or the bowel and the vagina. They can also develop between two blood vessels, such as between an artery and a vein or between two arteries.
Some people are born with a fistula. Other common causes of fistulas include:
- Complications from surgery
- Injury
- Infection
- Diseases, such as Crohn's disease or ulcerative colitis
Treatment depends on the cause of the fistula, where it is, and how bad it is. Some fistulas will close on their own. In some cases, you may need antibiotics and/or surgery.
[Learn More in MedlinePlus]
Shoulder Injuries and Disorders
Your shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). Your shoulders are the most movable joints in your body. They can also be unstable because the ball of the upper arm is larger than the shoulder socket that holds it. To remain in a stable or normal position, the shoulder must be anchored by muscles, tendons, and ligaments.
Because your shoulder can be unstable, it can be easily injured. Common problems include:
- Sprains and strains
- Dislocations
- Separations
- Tendinitis
- Bursitis
- Torn rotator cuffs
- Frozen shoulder
- Fractures (broken bones)
- Arthritis
Health care providers diagnose shoulder problems by using your medical history, a physical exam, and imaging tests.
Often, the first treatment for shoulder problems is RICE. This stands for Rest, Ice, Compression, and Elevation. Other treatments include exercise and medicines to reduce pain and swelling. If those don't work, you may need surgery.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
[Learn More in MedlinePlus]
Code History
- FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.