ICD-10 · PDGM grouping
M75 Shoulder lesions
All 30 codes in the M75 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
30
Can lead a claim
20
Cannot lead a claim
10
What CMS assigns to M75
20 of the 30 codes group to Musculoskeletal Rehabilitation; 10 are assigned no clinical group. None of the 30 is assigned a comorbidity subgroup. 20 of the 30 can lead a claim.
Every code in M75
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| M75.0 Adhesive capsulitis of shoulder | ||||
| M75.00 | Adhesive capsulitis of unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.01 | Adhesive capsulitis of right shoulder | Can lead a claim | E | None |
| M75.02 | Adhesive capsulitis of left shoulder | Can lead a claim | E | None |
| M75.1 Rotator cuff tear or rupture, not specified as traumatic | ||||
| M75.10 Unspecified rotator cuff tear or rupture, not specified as traumatic | ||||
| M75.100 | Unspecified rotator cuff tear or rupture of unspecified shoulder, not specified as traumaticCMS: Unsp rotatr-cuff tear/ruptr of unsp shoulder, not trauma | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.101 | Unspecified rotator cuff tear or rupture of right shoulder, not specified as traumaticCMS: Unsp rotatr-cuff tear/ruptr of right shoulder, not trauma | Can lead a claim | E | None |
| M75.102 | Unspecified rotator cuff tear or rupture of left shoulder, not specified as traumaticCMS: Unsp rotatr-cuff tear/ruptr of left shoulder, not trauma | Can lead a claim | E | None |
| M75.11 Incomplete rotator cuff tear or rupture not specified as traumatic | ||||
| M75.110 | Incomplete rotator cuff tear or rupture of unspecified shoulder, not specified as traumaticCMS: Incmpl rotatr-cuff tear/ruptr of unsp shoulder, not trauma | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.111 | Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumaticCMS: Incomplete rotatr-cuff tear/ruptr of r shoulder, not trauma | Can lead a claim | E | None |
| M75.112 | Incomplete rotator cuff tear or rupture of left shoulder, not specified as traumaticCMS: Incomplete rotatr-cuff tear/ruptr of l shoulder, not trauma | Can lead a claim | E | None |
| M75.12 Complete rotator cuff tear or rupture not specified as traumatic | ||||
| M75.120 | Complete rotator cuff tear or rupture of unspecified shoulder, not specified as traumaticCMS: Complete rotatr-cuff tear/ruptr of unsp shoulder, not trauma | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.121 | Complete rotator cuff tear or rupture of right shoulder, not specified as traumaticCMS: Complete rotatr-cuff tear/ruptr of r shoulder, not trauma | Can lead a claim | E | None |
| M75.122 | Complete rotator cuff tear or rupture of left shoulder, not specified as traumaticCMS: Complete rotatr-cuff tear/ruptr of left shoulder, not trauma | Can lead a claim | E | None |
| M75.2 Bicipital tendinitis | ||||
| M75.20 | Bicipital tendinitis, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.21 | Bicipital tendinitis, right shoulder | Can lead a claim | E | None |
| M75.22 | Bicipital tendinitis, left shoulder | Can lead a claim | E | None |
| M75.3 Calcific tendinitis of shoulder | ||||
| M75.30 | Calcific tendinitis of unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.31 | Calcific tendinitis of right shoulder | Can lead a claim | E | None |
| M75.32 | Calcific tendinitis of left shoulder | Can lead a claim | E | None |
| M75.4 Impingement syndrome of shoulder | ||||
| M75.40 | Impingement syndrome of unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.41 | Impingement syndrome of right shoulder | Can lead a claim | E | None |
| M75.42 | Impingement syndrome of left shoulder | Can lead a claim | E | None |
| M75.5 Bursitis of shoulder | ||||
| M75.50 | Bursitis of unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.51 | Bursitis of right shoulder | Can lead a claim | E | None |
| M75.52 | Bursitis of left shoulder | Can lead a claim | E | None |
| M75.8 Other shoulder lesions | ||||
| M75.80 | Other shoulder lesions, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.81 | Other shoulder lesions, right shoulder | Can lead a claim | E | None |
| M75.82 | Other shoulder lesions, left shoulder | Can lead a claim | E | None |
| M75.9 Shoulder lesion, unspecified | ||||
| M75.90 | Shoulder lesion, unspecified, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M75.91 | Shoulder lesion, unspecified, right shoulder | Can lead a claim | E | None |
| M75.92 | Shoulder lesion, unspecified, left shoulder | Can lead a claim | E | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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