ICD-10 Coding for Left Hip Pain(M25.552, G89.29)
Complete ICD-10-CM coding and documentation guide for Left Hip Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Hip Pain
M25.5Primary Range
Pain in joint
This range includes codes for joint pain, specifically for the left hip in this context.
Pain, not elsewhere classified
This range is used for chronic pain conditions, which may be applicable if the left hip pain is chronic.
Osteoarthritis of hip
This range is relevant if the left hip pain is due to osteoarthritis, confirmed by imaging.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M25.552 | Pain in left hip | Use when the patient presents with left hip pain without a more specific diagnosis. |
|
| G89.29 | Other chronic pain | Use when chronic pain is documented and the encounter is for pain management. |
|
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 left hip pain
Essential facts and insights about Left Hip Pain
Primary ICD-10-CM Codes for left hip pain
Decision Criteria
clinical Criteria
- Presence of left hip pain without specific etiology
documentation Criteria
- Documentation must include laterality and duration
Applicable To
- Localized pain in left hip
Excludes
- Osteoarthritis of left hip (M16.12)
Clinical Validation Requirements
- Documented left hip pain
- Physical exam findings such as reduced range of motion
Code-Specific Risks
- Risk of using unspecified codes when laterality is known
Coding Notes
- Ensure documentation specifies laterality and chronicity if applicable.
G89.29 - Other chronic pain
Use when chronic pain is documented and the encounter is for pain management.
Applicable To
- Chronic pain not elsewhere classified
Excludes
- Acute pain (G89.1)
Clinical Validation Requirements
- Documentation of chronic pain lasting more than 3 months
Coding Notes
Sequence first if the encounter is primarily for pain management.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other chronic pain
G89.29Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Unilateral primary osteoarthritis, left hip
M16.12Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Hip Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M25.552.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always document the side of the body affected.
Impact
Reimbursement: May lead to incorrect DRG assignment and affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces the specificity and quality of health data.
Mitigation Strategy
Ensure to use M25.552 for left hip pain when laterality is known.
Impact
Using G89.29 without proper documentation of chronicity.
Mitigation Strategy
Ensure documentation clearly states pain duration and management focus.
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 Left Hip Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Hip Pain
Use these documentation templates to ensure complete and accurate documentation for Left Hip Pain. These templates include all required elements for proper coding and billing.
Chronic left hip pain management
Specialty: OrthopedicsRequired Elements
- Pain location and laterality
- Duration and chronicity
- Physical exam findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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