2027 ICD-10-CM Diagnosis Code M25.511Pain in right shoulder
ICD-10-CM Codes›M00–M99›M20-M25›M25
- Billable — Valid for Submission
- Not Chronic
M25.511 is a billable ICD-10-CM diagnosis code for pain in right shoulder. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 555 through 556. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Musculoskeletal pain, not low back pain.
This medical diagnosis code is frequently used in Family Practice and Internal Medicine medical specialties to designate conditions such pain in joint.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Bilateral acromioclavicular joint pain
- Bilateral pain of shoulder blades
- Bilateral shoulder joint pain
- Pain due to and following arthroplasty of right shoulder
- Pain due to and following arthroplasty of shoulder
- Pain of acromioclavicular joint
- Pain of bilateral shoulder regions
- Pain of left acromioclavicular joint
- Pain of left shoulder blade
- Pain of left shoulder joint
- Pain of right acromioclavicular joint
- Pain of right shoulder blade
- Pain of right shoulder joint
- Pain of right shoulder region
- Pain of right sternoclavicular joint
- Pain of shoulder girdle
- Pain of sternoclavicular joint
- Pain radiating to right shoulder
- Scapulalgia
- Shoulder joint pain
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M25.511: its own notes plus those printed at M25.5, M25, block M00-M25, block M20-M25, and Chapter 13. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- Disorders affecting predominantly peripheral (limb) joints
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- arthropathic psoriasis (L40.5-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- compartment syndrome (traumatic) (T79.A-)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name M25.511, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming M25.511: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 3
These codes carry an Excludes2 note naming M25.511: its condition is not part of those codes, and both may be reported when the patient has both.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Pain
Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Each person feels pain differently, even if the reason for the pain is the same. Pain may be sharp or dull. It may be mild or severe. Pain may come and go, or it may be constant.
The full article covers:
- What is pain?
- What are the types of pain?
- What causes pain?
- How is pain diagnosed?
- What are the treatments for pain?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M25.511 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M25.511Overview
What is the ICD-10 code for pain in right shoulder?
The ICD-10-CM code for pain in right shoulder is M25.511 (sometimes written as M25511). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is M25.511 (Pain in shoulder) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pain in right shoulder on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does M25.511 group to?
When pain in right shoulder is the principal diagnosis on an inpatient stay, it groups to MS-DRG 555, 556, with relative weights from 0.8210 to 1.2908 depending on complications. Higher weights mean higher Medicare reimbursement.
What is the ICD-9 equivalent of M25.511?
Under the General Equivalence Mappings, pain in right shoulder converts to ICD-9-CM 719.41 (joint pain-shlder). The mapping is approximate, so confirm the match fits the documentation.
