FY2027
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ICD-10 Code for Shoulder Pain

Also searched as pain in shoulder

The ICD-10-CM code for shoulder pain depends on the side: M25.511 for the right side, M25.512 for the left and M25.519 when the side is not documented. M25.51 itself is a header code and cannot be billed. There is no bilateral code, so bilateral shoulder pain is reported with the right and left codes together. Valid for FY2027.

M25.51- is a header — not billableLaterality required

Shoulder pain ICD-10 codes at a glance

ConditionShoulder pain
RightM25.511 — Pain in right shoulder
LeftM25.512 — Pain in left shoulder
UnspecifiedM25.519 — Pain in unspecified shoulder
BillableNo — M25.51 is a header; use a code beneath it
Alphabetic Index entryPain, joint, shoulder
Code setICD-10-CM FY2027, valid October 1, 2026 – September 30, 2027

What is the ICD-10 code for left shoulder pain?

The ICD-10-CM code for left shoulder pain is M25.512 — Pain in left shoulder. M25.512 is billable.

Is there an ICD-10 code for bilateral shoulder pain?

No. ICD-10-CM has no bilateral code for shoulder pain, so bilateral shoulder pain is reported with both M25.511 (right) and M25.512 (left).

“If no bilateral code is provided and the condition is bilateral, assign separate codes for both the left and right side.”
ICD-10-CM Official Guidelines, Section I.B.13

When can the unspecified-side code for shoulder pain be used?

The unspecified-side code for shoulder pain is M25.519 — Pain in unspecified shoulder. M25.519 is billable.

“If the side is not identified in the medical record, assign the code for the unspecified side.”
ICD-10-CM Official Guidelines, Section I.B.13
“Codes for "unspecified" side should rarely be used, such as when the documentation in the record is insufficient to determine the affected side and it is not possible to obtain clarification.”
ICD-10-CM Official Guidelines, Section I.B.13

Can you code shoulder pain when the cause is known?

Shoulder pain is a symptom rather than a diagnosis. The official guidelines allow a symptom code while a related definitive diagnosis has not been established, and a symptom routinely associated with a confirmed disease is not coded separately:

“Codes that describe symptoms and signs, as opposed to diagnoses, are acceptable for reporting purposes when a related definitive diagnosis has not been established (confirmed) by the provider.”
ICD-10-CM Official Guidelines, Section I.B.4
“Signs and symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.”
ICD-10-CM Official Guidelines, Section I.B.5

What else changes the shoulder pain code?

When the record documents the pain as acute or chronic, a code from category G89 (for example G89.29, other chronic pain) can be added to the site code for more detail. Without that documentation — or a postprocedural, post-thoracotomy or neoplasm-related cause — G89 is not used.

“Codes in category G89, Pain, not elsewhere classified, may be used in conjunction with codes from other categories and chapters to provide more detail about acute or chronic pain and neoplasm-related pain, unless otherwise indicated below.”
ICD-10-CM Official Guidelines, Section I.C.6.b.1
“If the pain is not specified as acute or chronic, post-thoracotomy, postprocedural, or neoplasm-related, do not assign codes from category G89.”
ICD-10-CM Official Guidelines, Section I.C.6.b.1

What does the Tabular List say about M25.51?

The instructional notes that govern M25.51-, including those it inherits from its category and chapter. An Excludes1 note means the two codes are never reported together.

Excludes2 — not included here — inherited from Chapter 13

The conditions below are not part of M25.51, but a patient may have both at the same time. When documentation supports it, M25.51 and the excluded code may both 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)

Excludes2 — not included here — inherited from M20-M25

The conditions below are not part of M25.51, but a patient may have both at the same time. When documentation supports it, M25.51 and the excluded code may both be reported.

  • joints of the spine (M40-M54)

Excludes2 — not included here — inherited from M25

The conditions below are not part of M25.51, but a patient may have both at the same time. When documentation supports it, M25.51 and the excluded code may both be reported.

  • abnormality of gait and mobility (R26.-)
  • acquired deformities of limb (M20-M21)
  • calcification of bursa (M71.4-)
  • calcification of shoulder (joint) (M75.3)
  • calcification of tendon (M65.2-)
  • difficulty in walking (R26.2)
  • temporomandibular joint disorder (M26.6-)

Excludes2 — not included here — inherited from M25.5

The conditions below are not part of M25.51, but a patient may have both at the same time. When documentation supports it, M25.51 and the excluded code may both be reported.

Codes, descriptions and Index entries are from the official ICD-10-CM FY2027 release. Guideline text is quoted from the ICD-10-CM Official Guidelines for Coding and Reporting FY 2027. A code must always be verified in the Tabular List before it is reported. Data sources