ICD-10 Guide

Labral Tear

ICD-10 Coding for Labral Tear(S43.431A, M75.6)

PRIMARY SPECIALTYOrthopedics

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Labral Tear?

Essential facts and insights about Labral Tear

Key Clinical Considerations:

Shoulder pain, especially with overhead activities
Clicking or popping sensation in the shoulder
Limited range of motion

Clinical Information

Clinical Criteria & Documentation Requirements

Patient history including mechanism of injury
Physical exam findings such as tenderness and instability
Imaging results (MRI or CT) confirming labral tear

Coding Guidelines

Usage Guidelines & Examples

Use S43.432A for unspecified labral tears; specify laterality when applicable.
Common errors include using incorrect laterality codes or omitting encounter type.

Code Exclusions

Important Exclusions

Rotator cuff tears
Shoulder dislocations
Alternative codes for unspecified shoulder injuries

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

Athletes, particularly in contact sports
Patients with shoulder instability or previous shoulder injuries

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include detailed patient history, physical exam findings, and imaging results.

Billing considerations?

Ensure accurate coding based on the side affected and encounter type.

Labral Tear

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?

Labral Tear

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

Documentation requirements?

Billing considerations?