ICD-10 Coding for Right Upper Arm Pain(M79.621)
Complete ICD-10-CM coding and documentation guide for Right Upper Arm Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Upper Arm Pain
Key Information: ICD-10 code for right upper arm pain
Essential facts and insights about Right Upper Arm Pain
Primary ICD-10-CM Code for right upper arm pain
Decision Criteria
clinical Criteria
- Pain localized to the right upper arm with no underlying condition.
coding Criteria
- Avoid using unspecified codes when specific codes are available.
Applicable To
- Localized pain in right upper arm
Excludes
- Pain in shoulder (M25.511)
Clinical Validation Requirements
- Tenderness on palpation of right upper arm
- Pain with resisted elbow flexion
Code-Specific Risks
- Incorrectly coding as unspecified arm pain (M79.601)
Coding Notes
- Ensure documentation specifies 'right upper arm' to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute pain due to trauma
G89.11Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Pain in right shoulder
M25.511Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Upper Arm Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.621.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Always document the side of the body affected., Use templates that prompt for laterality.
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies 'right upper arm' to use M79.621.
Impact
Using unspecified codes when specific codes are available.
Mitigation Strategy
Regular training on documentation and coding specificity.
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 Upper Arm Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Upper Arm Pain
Use these documentation templates to ensure complete and accurate documentation for Right Upper Arm Pain. These templates include all required elements for proper coding and billing.
Orthopedic evaluation for arm pain
Specialty: OrthopedicsRequired Elements
- Location: Right upper arm
- Severity: Pain scale rating
- Onset: Acute or chronic
- Associated symptoms: Swelling, tenderness
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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