M70.811

Other soft tissue disorders related to use, overuse and pressure, right shoulder

FY2027Chapter 13: Diseases of the musculoskeletal system and connective tissue/M70–M79 Other soft tissue disorders

BillableComplete code, valid to report

M70.811 (also written M70811) is a billable ICD-10-CM diagnosis code for other soft tissue disorders related to use, overuse and pressure, right shoulder. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 75 codes in category M70 (Soft tissue disorders related to use, overuse and pressure). Its coding notes include a Use additional code instruction, 1 Excludes1 entry and 13 Excludes2 entries.

Use additional code

Add the listed code as a secondary code, if known.

Inherited from M70 Soft tissue disorders related to use, overuse and pressure
  • external cause code to identify activity causing disorder (Y93.-)

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from M70 Soft tissue disorders related to use, overuse and pressure

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from M70 Soft tissue disorders related to use, overuse and pressure
  • bursitis of shoulder (M75.5)
  • enthesopathies (M76-M77)
  • pressure ulcer (pressure area) (L89.-)
Also from chapter/block level (10 notes)
Inherited from Chapter 13 Diseases of the musculoskeletal system and connective tissue
  • 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)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the Musculoskeletal Rehabilitation clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Includes

Further defines or gives examples of the content of the category.

Inherited from M70 Soft tissue disorders related to use, overuse and pressure
  • soft tissue disorders of occupational origin

Notes

Also from chapter/block level (1 note)
Inherited from Chapter 13 Diseases of the musculoskeletal system and connective tissue
  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition