ICD-10 Coding for Acute Chest Pain(R07.9, R07.89, I20.0)
Complete ICD-10-CM coding and documentation guide for Acute Chest Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute Chest Pain
R07-R07.9Primary Range
Pain in throat and chest
This range includes codes for various types of chest pain, including unspecified and specific locations.
Ischemic heart diseases
Includes codes for angina and myocardial infarction, which are critical differential diagnoses for chest pain.
Pain, not elsewhere classified
Used for coding pain management scenarios, where pain is the primary focus of treatment.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R07.9 | Chest pain, unspecified | Use when documentation does not specify the type or location of chest pain. |
|
| R07.89 | Other chest pain | Use when the provider specifies a type or location of chest pain not classified elsewhere. |
|
| I20.0 | Unstable angina | Use when unstable angina is confirmed by clinical findings. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acute chest pain
Essential facts and insights about Acute Chest Pain
Primary ICD-10-CM Codes for acute chest pain
Decision Criteria
documentation Criteria
- Lack of specific details about the chest pain.
Applicable To
- Chest pain NOS
Excludes
- Heartburn (R12)
Clinical Validation Requirements
- Patient reports chest pain without specific characteristics or location.
Code-Specific Risks
- Risk of undercoding if more specific information is available.
Coding Notes
- Ensure documentation is reviewed for any specific details that could lead to a more specific code.
R07.89 - Other chest pain
Use when the provider specifies a type or location of chest pain not classified elsewhere.
Applicable To
- Anterior chest wall pain
Excludes
- Precordial pain (R07.81)
Clinical Validation Requirements
- Documentation specifies type or location of chest pain, such as musculoskeletal origin.
Coding Notes
Ensure that the documentation supports the specific type of chest pain coded.
I20.0 - Unstable angina
Use when unstable angina is confirmed by clinical findings.
Applicable To
- Crescendo angina
Excludes
- Stable angina (I20.8)
Clinical Validation Requirements
- Documentation of ischemic chest pain with ECG changes or troponin elevation.
Coding Notes
Ensure clinical documentation supports the diagnosis of unstable angina.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.10Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute Chest Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R07.9.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for reduced reimbursement due to unspecified coding.
Mitigation Strategy
Educate providers on the importance of detailed documentation., Implement structured documentation templates.
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Decreases the accuracy of clinical data.
Mitigation Strategy
Review documentation for specific characteristics of chest pain.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure documentation supports the use of specific codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acute Chest Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute Chest Pain
Use these documentation templates to ensure complete and accurate documentation for Acute Chest Pain. These templates include all required elements for proper coding and billing.
Patient presenting with chest pain in the emergency department
Specialty: Emergency MedicineRequired Elements
- Onset and duration of pain
- Character and severity of pain
- Radiation and associated symptoms
- Exacerbating and relieving factors
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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