ICD-10 Coding for Costovertebral Angle Sequelae(M54.6, M84.58XA, N13.5)
Complete ICD-10-CM coding and documentation guide for Costovertebral Angle Sequelae. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Costovertebral Angle Sequelae
M54-M54.9Primary Range
Dorsalgia
Includes codes for back pain, relevant for chronic pain at the costovertebral angle.
Disorders of continuity of bone
Includes codes for pathological fractures, relevant for sequelae of rib or vertebral fractures.
Obstructive and reflux uropathy
Includes codes for ureteral stricture, relevant for sequelae of kidney stones or infections.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M54.6 | Pain in thoracic spine | Use for chronic pain at the costovertebral angle without structural abnormalities. |
|
| M84.58XA | Pathological fracture in neoplastic disease, vertebra | Use for sequelae of rib or vertebral fractures from osteoporosis or trauma. |
|
| N13.5 | Crossing vessel and stricture of ureter without hydronephrosis | Use for chronic ureteral obstruction from prior kidney stone or infection. |
|
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 costovertebral angle sequelae
Essential facts and insights about Costovertebral Angle Sequelae
Primary ICD-10-CM Codes for costovertebral angle sequelae
Decision Criteria
clinical Criteria
- Pain persists >6 months with no acute findings
Applicable To
- Chronic pain at the costovertebral angle
Excludes
- Acute back pain
Clinical Validation Requirements
- Persistent pain >6 months
- Normal imaging findings
Code-Specific Risks
- Confusing with acute conditions
Coding Notes
- Ensure documentation specifies chronicity and anatomical location.
M84.58XA - Pathological fracture in neoplastic disease, vertebra
Use for sequelae of rib or vertebral fractures from osteoporosis or trauma.
Applicable To
- Sequelae of rib/vertebral fracture
Excludes
- Acute fractures
Clinical Validation Requirements
- Imaging showing healed fracture
- Pain localized to fracture site
Coding Notes
Ensure the 7th character 'A' is used for sequela.
N13.5 - Crossing vessel and stricture of ureter without hydronephrosis
Use for chronic ureteral obstruction from prior kidney stone or infection.
Applicable To
- Chronic ureteral obstruction
Excludes
- Active infection
Clinical Validation Requirements
- Imaging showing ureteral stricture
- Resolution of hydronephrosis
Coding Notes
Ensure documentation specifies chronicity and resolution of acute conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chronic pain due to trauma
G89.21Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Costovertebral Angle Sequelae to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M54.6.
Impact
Clinical: Inaccurate representation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure explicit linkage in documentation, Use specific terminology
Impact
Reimbursement: May lead to claim denials or reduced payments., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always confirm with imaging showing healed fracture.
Impact
Risk of using chronic pain codes without proper documentation.
Mitigation Strategy
Ensure documentation explicitly links pain to past conditions.
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 Costovertebral Angle Sequelae, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Costovertebral Angle Sequelae
Use these documentation templates to ensure complete and accurate documentation for Costovertebral Angle Sequelae. These templates include all required elements for proper coding and billing.
Chronic pain post-rib fracture
Specialty: Pain ManagementRequired Elements
- History of initial injury
- Current symptoms
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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