ICD-10 Coding for Arm Pain(M79.601, M79.602)
Complete ICD-10-CM coding and documentation guide for Arm Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Arm Pain
M79.601-M79.609Primary Range
Pain in arm, unspecified
This range is used for coding unspecified arm pain when the specific location or cause is not identified.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M79.601 | Pain in right arm | Use when the patient reports pain specifically in the right arm without a confirmed underlying condition. |
|
| M79.602 | Pain in left arm | Use when the patient reports pain specifically in the left arm without a confirmed underlying condition. |
|
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 arm pain
Essential facts and insights about Arm Pain
Primary ICD-10-CM Codes for arm pain
Decision Criteria
clinical Criteria
- Pain localized to the right arm without shoulder involvement.
Applicable To
- Right upper arm pain
- Right forearm pain
Excludes
- Pain in right shoulder (M25.511)
Clinical Validation Requirements
- Physical exam showing tenderness
- Patient history indicating pain location
Code-Specific Risks
- Risk of using unspecified codes when more specific codes are available.
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
M79.602 - Pain in left arm
Use when the patient reports pain specifically in the left arm without a confirmed underlying condition.
Applicable To
- Left upper arm pain
- Left forearm pain
Excludes
- Pain in left shoulder (M25.512)
Clinical Validation Requirements
- Physical exam showing tenderness
- Patient history indicating pain location
Coding Notes
Ensure laterality is documented to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute pain due to trauma
G89.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Arm Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.601.
Impact
Clinical: Inaccurate patient records., Regulatory: Non-compliance with ICD-10 guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Always include laterality in documentation., Use templates that prompt for specific details.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of patient records.
Mitigation Strategy
Always document and code the specific side of the body affected.
Impact
Using unspecified codes when specific laterality is documented.
Mitigation Strategy
Implement documentation checks to ensure laterality is always recorded.
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 Arm Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Arm Pain
Use these documentation templates to ensure complete and accurate documentation for Arm Pain. These templates include all required elements for proper coding and billing.
Patient presenting with arm pain
Specialty: OrthopedicsRequired Elements
- Location of pain
- Duration and onset
- Characteristics of pain
- Aggravating and relieving factors
- Associated symptoms
- Physical exam findings
- Diagnostic test results
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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