ICD-10 Coding for Right Great Toe Pain(M79.674, M20.11, L60.0)
Complete ICD-10-CM coding and documentation guide for Right Great Toe Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Great Toe Pain
M79.67-M79.674Primary Range
Pain in limb, foot, and toe
This range includes codes for pain in specific parts of the limb, including the right great toe.
Hallux valgus (acquired)
This range includes codes for bunions, which can cause pain in the right great toe.
Nail disorders
This range includes codes for nail disorders like ingrown toenails, which can cause toe 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 |
|---|---|---|---|
| M79.674 | Pain in right toe(s) | Use when pain is localized to the right great toe without a specific underlying condition. |
|
| M20.11 | Hallux valgus (acquired), right foot | Use when bunion is the primary cause of pain. |
|
| L60.0 | Ingrowing nail | Use when ingrown toenail is the primary cause of pain. |
|
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 great toe pain
Essential facts and insights about Right Great Toe Pain
Primary ICD-10-CM Codes for right great toe pain
Decision Criteria
clinical Criteria
- Pain localized to right great toe with no identifiable cause
documentation Criteria
- Document laterality and specific toe
Applicable To
- Idiopathic pain in right great toe
Clinical Validation Requirements
- Pain localized to right great toe without identifiable cause
- Exclusion of systemic causes like gout
Code-Specific Risks
- Risk of under-documenting the cause of pain if present
Coding Notes
- Ensure laterality and specific toe are documented.
M20.11 - Hallux valgus (acquired), right foot
Use when bunion is the primary cause of pain.
Applicable To
- Bunion on right foot
Excludes
- Pain in right toe (M79.674)
Clinical Validation Requirements
- Dorsal prominence and lateral deviation of great toe
- Confirmed via X-ray
Coding Notes
Document the presence of bunion and its impact on pain.
L60.0 - Ingrowing nail
Use when ingrown toenail is the primary cause of pain.
Applicable To
- Ingrown toenail
Excludes
- Pain in right toe (M79.674)
Clinical Validation Requirements
- Nail plate embedding into lateral nail fold
- Presence of erythema or purulence
Coding Notes
Ensure documentation of nail condition and its impact on pain.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Tinea unguium
B35.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Great Toe Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.674.
Impact
Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always document the side of the body affected., Use specific codes for right or left side.
Impact
Reimbursement: May lead to incorrect reimbursement rates., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Specify the exact digit and laterality.
Impact
Using non-specific codes for toe pain can trigger audits.
Mitigation Strategy
Ensure documentation supports the specific code 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 Right Great Toe Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Great Toe Pain
Use these documentation templates to ensure complete and accurate documentation for Right Great Toe Pain. These templates include all required elements for proper coding and billing.
Podiatry Progress Note
Specialty: PodiatryRequired Elements
- Pain severity and location
- Physical exam findings
- Imaging results
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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