Orthopedic Coding Alert

Question: What diagnosis code should we submit for shoulder impingement syndrome?

New Mexico Subscriber

Answer: The correct choice is 726.2 (Other affectations of shoulder region, not elsewhere classified).

Finding it: The ICD-9 index does not include "shoulder" in the entries under "impingement," so you must search elsewhere for clues. Impingement pain could be caused by bursitis or tendonitis of the rotator cuff.

Shoulder tendonitis and tenosynovitis diagnoses include 726.10 (Disorders of bursae and tendons in shoulder region, unspecified) and 726.11 (Calcifying tendonitis of shoulder); shoulder bursitis also falls under 726.10. If your physician hasn't documented a specific condition (such as tendonitis or bursitis) related to the impingement, however, you should submit a less specific code -- which is why 726.2 is your best option.