ICD-10 Coding for Left Rib Pain(R07.89, S22.42XA, M94.0)
Complete ICD-10-CM coding and documentation guide for Left Rib Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Rib Pain
R07.0-R07.9Primary Range
Pain in throat and chest
This range includes codes for chest pain, including rib pain, which is relevant for left rib pain coding.
Fracture of ribs
This range includes codes for rib fractures, which may be relevant if the left rib pain is due to trauma.
Tietze's disease
This code is used for Tietze syndrome, which can cause left rib pain due to costochondral swelling.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R07.89 | Other chest pain | Use when documenting non-traumatic left rib pain with specified laterality. |
|
| S22.42XA | Fracture of one rib, left side, initial encounter | Use for initial encounter of left rib fracture due to trauma. |
|
| M94.0 | Tietze's disease | Use when left rib pain is due to Tietze syndrome with swelling. |
|
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 rib pain
Essential facts and insights about Left Rib Pain
Primary ICD-10-CM Codes for left rib pain
Decision Criteria
clinical Criteria
- Presence of localized tenderness and exclusion of trauma.
documentation Criteria
- Specific mention of left rib pain and its characteristics.
Clinical Validation Requirements
- Documentation of left-sided rib pain
- Exclusion of trauma
- Relation to respiration
Code-Specific Risks
- Risk of using unspecified chest pain code R07.9 instead of R07.89.
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
S22.42XA - Fracture of one rib, left side, initial encounter
Use for initial encounter of left rib fracture due to trauma.
Applicable To
- Traumatic left rib fracture
Excludes
- Non-traumatic rib pain (R07.89)
Clinical Validation Requirements
- Imaging confirmation of fracture
- Documentation of trauma mechanism
Coding Notes
Ensure trauma is documented and fracture is confirmed by imaging.
M94.0 - Tietze's disease
Use when left rib pain is due to Tietze syndrome with swelling.
Applicable To
- Tietze syndrome
Excludes
- Costochondritis without swelling (R07.81)
Clinical Validation Requirements
- Palpable costochondral swelling
- Pain reproducible on palpation
Coding Notes
Ensure swelling is documented to differentiate from costochondritis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Left Rib Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R07.89.
Impact
Clinical: May lead to incorrect diagnosis and treatment., Regulatory: Non-compliance with ICD-10 coding guidelines., Financial: Potential for denied claims due to unspecified coding.
Mitigation Strategy
Always ask and document which side the pain is on.
Impact
Reimbursement: May lead to lower reimbursement due to unspecified coding., Compliance: Non-compliance with specificity requirements., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies rib pain and laterality.
Impact
Risk of using unspecified codes for rib pain.
Mitigation Strategy
Ensure documentation includes specific details about the pain location and characteristics.
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 Rib Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Rib Pain
Use these documentation templates to ensure complete and accurate documentation for Left Rib Pain. These templates include all required elements for proper coding and billing.
Non-traumatic left rib pain
Specialty: General PracticeRequired Elements
- Location of pain
- Onset and duration
- Relation to respiration
- Exclusion of trauma
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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