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ICD-10 Coding for Rib Pain(R07.89, R07.81, S22.3-)

Complete ICD-10-CM coding and documentation guide for Rib Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Chest Wall PainIntercostal PainPleurodyniacostal painthoracic pain

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Related ICD-10 Code Ranges

Complete code families applicable to Rib Pain

R07.1-R07.9Primary Range

Pain in throat and chest

This range includes codes for various types of chest pain, including rib pain.

S22.3-S22.4

Fracture of ribs

This range is used for coding rib fractures, which may present with rib pain.

M94.0

Tietze's disease

This code is used for Tietze syndrome, a condition that can cause rib pain.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
R07.89Other chest painUse for unspecified rib pain when no specific cause is documented.
  • Pain localization diagram
  • Documentation of pain characteristics
R07.81PleurodyniaUse when pleurodynia is specifically documented by the provider.
  • Documentation of sudden onset and movement-related pain
S22.3-Fracture of one ribUse when a single rib fracture is confirmed by imaging.
  • Imaging confirmation of rib fracture

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 rib pain

Essential facts and insights about Rib Pain

The ICD-10 code for unspecified rib pain is R07.89, used when no specific cause is documented.

Primary ICD-10-CM Codes for rib pain

R07.89
Other chest pain
Billable Code

Decision Criteria

clinical Criteria

  • Pain is localized to the ribs without specific cause.

Applicable To

  • Unspecified rib pain

Excludes

  • Pain due to rib fracture (S22.3-)

Clinical Validation Requirements

  • Pain localization diagram
  • Documentation of pain characteristics

Code-Specific Risks

  • Lack of specificity can lead to audit issues.

Coding Notes

  • Ensure documentation specifies the nature and location of pain.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Fibromyalgia

M79.7
Use when rib pain is part of fibromyalgia symptoms.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Pleurodynia

R07.81
Use when pain is sudden and severe, often movement-related.

Other chest pain

R07.89
Use when pain is not sudden or movement-related.

Multiple rib fractures

S22.4-
Use when more than one rib is fractured.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting 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: Inaccurate clinical records., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.

Mitigation Strategy

Always specify laterality in documentation., Use templates to ensure completeness.

Impact

Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Use S22.3- for rib fractures with R07.89 for pain.

Impact

Incorrect use of laterality and 7th character.

Mitigation Strategy

Implement thorough documentation review processes.

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 Rib Pain, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Rib Pain

Use these documentation templates to ensure complete and accurate documentation for Rib Pain. These templates include all required elements for proper coding and billing.

Emergency Department Rib Pain

Specialty: Emergency Medicine

Required Elements

  • Pain location and characteristics
  • Imaging findings
  • Injury mechanism

Example Documentation

Patient presents with sharp, localized rib pain post-MVA. Imaging confirms fracture of the 8th rib.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has rib pain.
Good Documentation Example
Patient reports sharp, localized pain in the right 8th rib following a fall. Imaging confirms fracture.
Explanation
The good example provides specific location, cause, and imaging confirmation, improving coding accuracy.

Need help with ICD-10 coding for Rib Pain? Ask your questions below.

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