Billable FY2026 ICD-10-CM diagnosis code, shoulder region. What it covers, how to bill it cleanly, and what these patients sound like when they call.
Pain in the left shoulder, mirroring M25.511. Part of the M25.51- family that exists to carry laterality on shoulder pain presentations.
| Code | Description |
|---|---|
| M25.511 | Pain in right shoulder |
| M25.519 | Pain in unspecified shoulder |
| M25.461 | Effusion, right knee |
| M25.462 | Effusion, left knee |
| M25.469 | Effusion, unspecified knee |
| M25.551 | Pain in right hip |
The screening question that matters on shoulder-pain calls is night pain plus weakness, which pushes toward cuff pathology and a sooner slot. Phone intake that captures this changes scheduling priority appropriately.
ClinicFlow's voice AI runs this intake on every call for sports medicine practices: capturing the story, applying your routing rules, and booking the right visit type with the right surgeon. See voice AI for sports medicine practices or the Call Library for how each call type is handled.
M25.512 is the FY2026 ICD-10-CM code for pain in left shoulder. Pain in the left shoulder, mirroring M25.
Left-sided pain with exertional features deserves a cardiac question before an orthopedic slot. Triage protocols should route chest-adjacent presentations conservatively.
Yes. M25.512 appears in the official FY2026 ICD-10-CM code set (effective October 1, 2025). ICD-10-CM is public-domain CMS data; verify annually as codes are revised each fiscal year.
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