ICD-10 Coding for Pain of Right Hip(M25.551, M16.11, M70.61)
Complete ICD-10-CM coding and documentation guide for Pain of Right Hip. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pain of Right Hip
M25.5Primary Range
Pain in joint
This range includes codes for joint pain, specifically M25.551 for right hip pain.
Osteoarthritis of hip
Includes codes for osteoarthritis, relevant if the pain is due to this condition.
Trochanteric bursitis
Includes codes for bursitis, relevant if the pain is due to trochanteric bursitis.
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 pain is unspecified and no specific condition like OA or bursitis is confirmed. |
|
| M16.11 | Unilateral primary osteoarthritis, right hip | Use when osteoarthritis is confirmed via imaging. |
|
| M70.61 | Trochanteric bursitis, right hip | Use when bursitis is confirmed via clinical examination. |
|
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 Pain of Right Hip
Primary ICD-10-CM Codes for pain of right hip
Decision Criteria
clinical Criteria
- Pain localized to right hip without specific diagnosis.
documentation Criteria
- Lack of specific diagnosis like OA or bursitis.
Applicable To
- Unspecified right hip pain
Clinical Validation Requirements
- Pain localized to right hip without confirmed etiology
Code-Specific Risks
- Risk of claim denial if used without excluding specific conditions.
Coding Notes
- Ensure laterality is specified and exclude specific conditions before using.
M16.11 - Unilateral primary osteoarthritis, right hip
Use when osteoarthritis is confirmed via imaging.
Applicable To
- Primary osteoarthritis of right hip
Excludes
- Pain in right hip (M25.551)
Clinical Validation Requirements
- Radiographic evidence of joint space narrowing
Coding Notes
Ensure imaging supports the diagnosis.
M70.61 - Trochanteric bursitis, right hip
Use when bursitis is confirmed via clinical examination.
Applicable To
- Bursitis of right hip
Excludes
- Pain in right hip (M25.551)
Clinical Validation Requirements
- Clinical examination confirming bursitis
Coding Notes
Ensure clinical findings support the diagnosis.
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 Pain of Right Hip to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M25.551.
Impact
Clinical: Leads to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure imaging results are included in documentation.
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation.
Mitigation Strategy
Confirm no specific condition like OA or bursitis is present before using.
Impact
Reimbursement: Potential claim rejections., Compliance: Violates ICD-10 coding rules., Data Quality: Leads to incomplete records.
Mitigation Strategy
Always document laterality clearly.
Impact
Using unspecified codes when specific ones are available.
Mitigation Strategy
Always verify if a more specific code can be used.
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 of Right Hip, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pain of Right Hip
Use these documentation templates to ensure complete and accurate documentation for Pain of Right Hip. These templates include all required elements for proper coding and billing.
Orthopedic Evaluation for Hip Pain
Specialty: OrthopedicsRequired Elements
- Location and laterality of pain
- Duration and severity
- Physical examination findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Pain of Right Hip? Ask your questions below.