ICD-10 Coding for Right Leg Pain(M79.604, M79.607)
Complete ICD-10-CM coding and documentation guide for Right Leg Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Leg Pain
M79.60-M79.67Primary Range
Pain in limb
This range includes codes for pain in specific parts of the limb, including the right leg.
Pain, not elsewhere classified
These codes are used for pain management scenarios, such as chronic or acute 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 |
|---|---|---|---|
| M79.604 | Pain in right leg | Use when the pain is generalized in the right leg without specific localization. |
|
| M79.607 | Pain in right lower leg | Use when pain is specifically in the lower leg, such as the calf. |
|
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 leg pain
Essential facts and insights about Right Leg Pain
Primary ICD-10-CM Codes for right leg pain
Decision Criteria
clinical Criteria
- Pain localized to the right leg without specific injury
Applicable To
- Generalized right thigh pain
Excludes
- Pain in right hip (M79.651)
Clinical Validation Requirements
- Documented location of pain in the right leg
- Negative imaging for fractures
Code-Specific Risks
- Risk of using unspecified codes when specifics are available
Coding Notes
- Ensure documentation specifies the exact location and nature of the pain.
M79.607 - Pain in right lower leg
Use when pain is specifically in the lower leg, such as the calf.
Applicable To
- Pain in right calf
Excludes
- Pain in right thigh (M79.604)
Clinical Validation Requirements
- Palpation findings indicating localized pain in the calf
- Negative D-dimer for DVT exclusion
Coding Notes
Document specific location and characteristics of pain.
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 Leg Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.604.
Impact
Clinical: Leads to inaccurate diagnosis and treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Use standardized templates., Regular training on documentation standards.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Could lead to compliance issues during audits., Data Quality: Affects the accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the exact location of pain to use the correct code.
Impact
High risk of audit if unspecified codes are used when specific codes are available.
Mitigation Strategy
Ensure documentation specifies the exact location and nature of pain.
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 Leg Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Leg Pain
Use these documentation templates to ensure complete and accurate documentation for Right Leg Pain. These templates include all required elements for proper coding and billing.
Right Leg Pain Evaluation
Specialty: OrthopedicsRequired Elements
- Location of pain
- Quality and severity of pain
- Aggravating and alleviating factors
- Imaging and diagnostic findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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