ICD-10 Coding for Right Groin Pain(R10.31, S76.811A)
Complete ICD-10-CM coding and documentation guide for Right Groin Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Groin Pain
R10.30-R10.33Primary Range
Pain localized to lower abdomen
Includes codes for pain in the lower abdomen, which encompasses right groin pain.
Injury of muscle and tendon at hip and thigh level
Covers muscle strains and injuries relevant to groin 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 |
|---|---|---|---|
| R10.31 | Right lower quadrant pain | Use when pain is localized to the right lower quadrant without a specific diagnosis. |
|
| S76.811A | Strain of right adductor muscle, initial encounter | Use when there is a confirmed strain of the right adductor muscle. |
|
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 Right Groin Pain
Primary ICD-10-CM Codes for right groin pain
Decision Criteria
clinical Criteria
- Pain localized to right lower quadrant without specific diagnosis
Applicable To
- Right groin pain
Excludes
- Pain due to specific conditions like hernia or muscle strain
Clinical Validation Requirements
- Documentation of pain localized to the right lower quadrant
- Absence of a more specific diagnosis
Code-Specific Risks
- Risk of under-documentation if specific cause is not ruled out
Coding Notes
- Ensure documentation specifies the quadrant and rules out specific conditions.
S76.811A - Strain of right adductor muscle, initial encounter
Use when there is a confirmed strain of the right adductor muscle.
Applicable To
- Right adductor muscle strain
Excludes
- Chronic muscle strain (use G89.29 if chronic)
Clinical Validation Requirements
- Positive orthopedic tests such as resisted adduction test
- Imaging confirmation of muscle strain
Coding Notes
Document the mechanism of injury and confirm with imaging.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Groin Pain 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: Could result in audit findings., Financial: Potential for denied claims.
Mitigation Strategy
Use structured templates for documentation, Train staff on detailed pain assessment
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of medical records.
Mitigation Strategy
Always use the most specific code available, such as R10.31 for right lower quadrant pain.
Impact
Risk of audits due to use of unspecified codes.
Mitigation Strategy
Use the most specific codes available and ensure documentation supports code selection.
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 Groin Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Groin Pain
Use these documentation templates to ensure complete and accurate documentation for Right Groin Pain. These templates include all required elements for proper coding and billing.
Acute right groin pain in an athlete
Specialty: Sports MedicineRequired Elements
- Pain location and severity
- Mechanism of injury
- Clinical tests performed
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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