Date amended:
Statements of Principles
Current RMA Instruments
Reasonable Hypothesis SOP
72 of 2020
Balance of Probabilities SOP
73 of 2020
Changes from previous Instruments


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

Adhesive capsulitis involves shoulder pain and the gradual loss of active and passive shoulder movement, with partial or complete resolution over months or years. 

Confirming the diagnosis

The diagnosis is made on clinical grounds, based on medical history and physical examination.  Diagnostic imaging is generally not helpful, except to eliminate other conditions.

The relevant medical specialist is an orthopaedic surgeon or a rheumatologist.

Additional diagnoses covered by SOP
  • Frozen shoulder
Conditions not covered by SOP
  • Rotator cuff syndrome*

* another SOP applies

Clinical onset

Clinical onset will be at the time of onset of symptoms that are subsequently confirmed to be due to adhesive capsulitis.

Clinical worsening

The condition is generally self-limiting, although complete resolution may not occur.  Permanent worsening is unlikely to occur.  Available treatment options are generally ineffective and do not improve outcomes.