M75.122 ICD-10-CM Code: Complete rotator cuff tear or rupture of left shoulder, not specified as traumatic
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the musculoskeletal system and connective tissue (M00-M99) / Other soft tissue disorders (M70-M79)
M75.122
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceComplete rotator cuff tear or rupture of left shoulder, not specified as traumatic
A complete tear or rupture of the rotator cuff muscles in the left shoulder that occurred without a specific traumatic injury.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for M75.122 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for M75.122 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for M75.122 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for M75.122 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for M75.122 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for M75.122 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for M75.122 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is M75.122 an HCC code?
No. M75.122 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
M75.122 is the ICD-10-CM diagnosis code for complete rotator cuff tear or rupture of left shoulder, not specified as traumatic. A complete tear or rupture of the rotator cuff muscles in the left shoulder that occurred without a specific traumatic injury. M75.122 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering other soft tissue disorders (m70-m79).
M75.122 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code when imaging or clinical documentation confirms a full-thickness tear of the left shoulder.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M75.122 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when imaging or clinical documentation confirms a full-thickness tear of the left shoulder
- •Verify the tear is non-traumatic in origin rather than from a specific injury event