Information for Patients
What is a dislocated shoulder?
Your shoulder joint is made up of three bones: your collarbone, your shoulder blade, and your upper arm bone. The top of your upper arm bone is shaped like a ball. This ball fits into a cuplike socket in your shoulder blade. A shoulder dislocation is an injury that happens when the ball pops out of your socket. A dislocation may be partial, where the ball is only partially out of the socket. It can also be a full dislocation, where the ball is completely out of the socket.
What causes a dislocated shoulder?
Your shoulders are the most movable joints in your body. They are also the most commonly dislocated joints.
The most common causes of shoulder dislocations are:
- Sports injuries
- Accidents, including traffic accidents
- Falling on your shoulder or outstretched arm
- Seizures and electric shocks, which can cause muscle contractions that pull the arm out of place
Who is at risk for a dislocated shoulder?
A dislocated shoulder can happen to anyone, but they are more common in young men, who are more often involved in sports and other physical activities. Older adults, especially women, are also at higher risk because they are more likely to fall.
What are the symptoms of a dislocated shoulder?
The symptoms of a dislocated shoulder include:
- Severe shoulder pain
- Swelling and bruising of your shoulder or upper arm
- Numbness and/or weakness in your arm, neck, hand, or fingers
- Trouble moving your arm
- Your arm seems to be out of place
- Muscle spasms in your shoulder
If you are having these symptoms, get medical treatment right away.
How is a dislocated shoulder diagnosed?
To make a diagnosis, your health care provider will take a medical history and examine your shoulder. Your provider may also ask you to get an x-ray to confirm the diagnosis.
What are the treatments for a dislocated shoulder?
The treatment for dislocated shoulder usually involves three steps:
- The first step is a closed reduction, a procedure in which your health care provider puts the ball of your upper arm back into the socket. You may first get medicine to relieve the pain and relax your shoulder muscles. Once the joint is back in place, the severe pain should end.
- The second step is wearing a sling or other device to keep your shoulder in place. You will wear it for a few days to several weeks.
- The third step is rehabilitation, once the pain and swelling have improved. You will do exercises to improve your range of motion and strengthen your muscles.
You may need surgery if you injure the tissues or nerves around the shoulder or if you get repeated dislocations.
A dislocation can make your shoulder unstable. When that happens, it takes less force to dislocate it. This means that there is a higher risk of it happening again. Your health care provider may ask you to continue doing some exercises to prevent another dislocation.
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.