ICD-10 Coding for Right Side Rib Pain(R07.89, S22.31XA, M94.0)
Complete ICD-10-CM coding and documentation guide for Right Side Rib Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Side Rib Pain
R07.1-R07.9Primary Range
Pain in throat and chest
This range includes codes for chest pain, including rib pain without specific etiology.
Fracture of ribs
This range covers rib fractures, which may be relevant if trauma is involved.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R07.89 | Other chest pain | Use when rib pain is present without a specific cause or trauma. |
|
| S22.31XA | Fracture of one rib, right side, initial encounter for closed fracture | Use when a fracture is confirmed via imaging. |
|
| M94.0 | Tietze's syndrome | Use when costochondritis is diagnosed. |
|
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 side rib pain
Essential facts and insights about Right Side Rib Pain
Primary ICD-10-CM Codes for right side rib pain
Decision Criteria
clinical Criteria
- Pain localized to rib area without trauma
Applicable To
- Rib pain without confirmed etiology
Excludes
- Pain due to pleurodynia
Clinical Validation Requirements
- Pain localized to right rib cage
- No trauma or specific etiology confirmed
Code-Specific Risks
- Misclassification if trauma or specific condition is present
Coding Notes
- Ensure documentation specifies absence of trauma or specific condition.
S22.31XA - Fracture of one rib, right side, initial encounter for closed fracture
Use when a fracture is confirmed via imaging.
Applicable To
- Closed fracture of right rib
Excludes
- Open fracture of rib
Clinical Validation Requirements
- X-ray or imaging confirmation of fracture
- Documented trauma history
Coding Notes
Ensure imaging confirms fracture before coding.
M94.0 - Tietze's syndrome
Use when costochondritis is diagnosed.
Applicable To
- Costochondritis
Excludes
- Rib fracture
Clinical Validation Requirements
- Swelling and tenderness at costochondral junction
- Reproducible pain on palpation
Coding Notes
Document swelling and tenderness for accurate coding.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pleurodynia
R07.81Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Side 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: Leads to generic coding, missing specific conditions, Regulatory: Potential audit issues due to lack of specificity, Financial: May affect reimbursement rates
Mitigation Strategy
Always document suspected or confirmed causes, Use imaging to confirm fractures
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use S22.3- codes for fractures or R07.89 if no fracture is confirmed.
Impact
Using incorrect codes for rib pain can lead to audits.
Mitigation Strategy
Ensure documentation specifies trauma and imaging results.
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 Side Rib Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Side Rib Pain
Use these documentation templates to ensure complete and accurate documentation for Right Side Rib Pain. These templates include all required elements for proper coding and billing.
Emergency Department Note (Trauma)
Specialty: Emergency MedicineRequired Elements
- Indication of trauma
- Imaging results
- Physical examination findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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