ICD-10 Coding for Pain in Right Groin(R10.31, S76.811A)
Complete ICD-10-CM coding and documentation guide for Pain in Right Groin. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pain in Right Groin
R10.30-R10.33Primary Range
Pain localized to specific abdominal regions
Includes codes for right lower quadrant pain, which encompasses right groin pain.
Injury of muscle and tendon at hip and thigh level
Includes codes for muscle strains, such as right adductor strain, relevant when groin pain is due to muscle injury.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R10.31 | Right lower quadrant pain | Use when pain is localized to the right groin without a confirmed specific cause. |
|
| S76.811A | Strain of right adductor muscle, fascia and tendon at thigh level, initial encounter | Use when groin pain is due to an acute adductor strain. |
|
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 right groin pain
Essential facts and insights about Pain in Right Groin
Primary ICD-10-CM Codes for pain in right groin
Decision Criteria
clinical Criteria
- Pain localized to the right inguinal region without specific diagnosis.
Applicable To
- Right inguinal pain
Excludes
- Pain due to specific conditions like hernia or appendicitis
Clinical Validation Requirements
- Tenderness localized to right inguinal region
- Negative imaging for specific pathologies
Code-Specific Risks
- Risk of under-documenting specific causes leading to incorrect coding.
Coding Notes
- Ensure documentation specifies the exact location and nature of the pain.
S76.811A - Strain of right adductor muscle, fascia and tendon at thigh level, initial encounter
Use when groin pain is due to an acute adductor strain.
Applicable To
- Right adductor strain
Excludes
- Chronic conditions not related to acute strain
Clinical Validation Requirements
- Positive resisted hip adduction test
- MRI showing muscle tear
Coding Notes
Document the mechanism of injury clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Inguinal hernia
K40.90Differential 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 Pain in Right Groin to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.31.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Train staff on the importance of detailed documentation., Use templates that prompt for specific location details.
Impact
Reimbursement: Incorrect coding may lead to reduced reimbursement., Compliance: Non-compliance with coding specificity requirements., Data Quality: Decreased accuracy in clinical data reporting.
Mitigation Strategy
Specify laterality using R10.31 for right-sided pain.
Impact
Audits may focus on whether documentation supports the specificity of the coded condition.
Mitigation Strategy
Ensure all documentation includes precise anatomical descriptions.
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 Pain in Right Groin, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pain in Right Groin
Use these documentation templates to ensure complete and accurate documentation for Pain in Right Groin. These templates include all required elements for proper coding and billing.
Acute right groin pain after sports activity
Specialty: OrthopedicsRequired Elements
- Location of pain
- Mechanism of injury
- Physical exam findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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