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Adhesive Capsulitis of the Shoulder N010

Document
Last amended 
24 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
7 of 2012
Balance of Probabilities SOP
8 of 2012
Changes from Previous Instruments:

SOP Bulletin 156

ICD Coding:
  • ICD-9-CM Codes: 726.0
  • ICD-10-AM Codes: M75.0

Adhesive capsulitis involves painful, progressive loss of shoulder movement, with partial or complete resolution over months or years.

Is specific diagnostic evidence required to apply the SOP? – No.
Are there sub-factors that require specific information? – No. 
Additional diagnoses covered by SOP
  • Frozen shoulder
Conditions not covered by SOP
  • Rotator cuff syndrome, ICD code 726.10
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. generate a diagnostic report, or;
  3. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • Report from an orthopaedic surgeon or rheumatologist