ICD-10 Coding for Right Hip Joint Pain(M25.551, M16.11, M70.61)
Complete ICD-10-CM coding and documentation guide for Right Hip Joint Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Hip Joint 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 |
|---|---|---|---|
| M25.551 | Pain in right hip | Use when the patient presents with right hip pain without a specific underlying condition. |
|
| M16.11 | Unilateral primary osteoarthritis, right hip | Use when imaging confirms osteoarthritis. |
|
| M70.61 | Trochanteric bursitis, right hip | Use when clinical exam confirms bursitis. |
|
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 hip pain
Essential facts and insights about Right Hip Joint Pain
Primary ICD-10-CM Codes for pain of right hip joint
Decision Criteria
clinical Criteria
- Pain localized to the right hip without specific diagnosis
coding Criteria
- No imaging evidence of osteoarthritis or bursitis
Applicable To
- Localized right hip pain
Excludes
- Pain due to specific conditions like bursitis or osteoarthritis
Clinical Validation Requirements
- Clinical examination showing pain without specific etiology
- Negative imaging for specific pathologies
Code-Specific Risks
- Overuse when specific conditions are identified
Coding Notes
- Ensure documentation specifies the absence of specific conditions.
M16.11 - Unilateral primary osteoarthritis, right hip
Use when imaging confirms osteoarthritis.
Applicable To
- Osteoarthritis of right hip
Excludes
- Pain without osteoarthritis
Clinical Validation Requirements
- X-ray or MRI showing joint space narrowing
Coding Notes
Ensure imaging results are documented.
M70.61 - Trochanteric bursitis, right hip
Use when clinical exam confirms bursitis.
Applicable To
- Bursitis of right hip
Excludes
- Pain without bursitis
Clinical Validation Requirements
- Clinical exam showing tenderness over greater trochanter
Coding Notes
Document clinical findings supporting bursitis.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Hip Joint Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M25.551.
Impact
Clinical: Ambiguity in treatment location., Regulatory: Non-compliance with ICD-10 requirements., Financial: Potential claim denials.
Mitigation Strategy
Always specify right or left in documentation.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use M70.61 for confirmed bursitis cases.
Impact
Risk of using non-specific codes when specific conditions are documented.
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 Right Hip Joint Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Hip Joint Pain
Use these documentation templates to ensure complete and accurate documentation for Right Hip Joint Pain. These templates include all required elements for proper coding and billing.
Chronic Right Hip Pain
Specialty: OrthopedicsRequired Elements
- Pain description
- Duration
- Aggravating factors
- Physical exam findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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