ICD-10 Coding for Axillary Pain(M25.512, G54.0)
Complete ICD-10-CM coding and documentation guide for Axillary Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Axillary Pain
M25.51-M25.519Primary Range
Pain in joint, shoulder region
Covers musculoskeletal pain in the shoulder region, including axillary pain.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M25.512 | Pain in left shoulder | Use for musculoskeletal axillary pain, especially when related to shoulder movement. |
|
| G54.0 | Brachial plexus disorders | Use for confirmed neurological causes of axillary pain. |
|
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 axillary pain
Essential facts and insights about Axillary Pain
Primary ICD-10-CM Codes for axillary pain
Decision Criteria
clinical Criteria
- Pain worsens with shoulder movement
Applicable To
- Musculoskeletal axillary pain
Excludes
- Neuropathic pain (G54.0)
Clinical Validation Requirements
- Reduced range of motion in shoulder
- Tenderness over axillary region
Code-Specific Risks
- Incorrect laterality can lead to coding errors.
Coding Notes
- Ensure laterality is specified to avoid unspecified coding.
G54.0 - Brachial plexus disorders
Use for confirmed neurological causes of axillary pain.
Applicable To
- Axillary neuropathy
Excludes
- Musculoskeletal pain (M25.51-)
Clinical Validation Requirements
- EMG showing axillary nerve dysfunction
- Weakness in deltoid muscle
Coding Notes
Confirm with EMG before coding.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Axillary Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M25.512.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential for claim denials.
Mitigation Strategy
Always document the suspected or confirmed cause of pain., Use templates to ensure comprehensive documentation.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure to specify laterality with M25.512 or M25.511.
Impact
Using unspecified codes when specific codes are available.
Mitigation Strategy
Regular training on ICD-10 updates and specificity requirements.
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 Axillary Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Axillary Pain
Use these documentation templates to ensure complete and accurate documentation for Axillary Pain. These templates include all required elements for proper coding and billing.
Chronic axillary pain evaluation
Specialty: OrthopedicsRequired Elements
- History of present illness
- Physical examination findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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