ICD-10 Coding for Tailbone Pain(M53.3, S33.2XXA)
Complete ICD-10-CM coding and documentation guide for Tailbone Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Tailbone 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 |
|---|---|---|---|
| M53.3 | Sacrococcygeal disorders, not elsewhere classified | Use for non-traumatic coccydynia, chronic pain, idiopathic or degenerative conditions. |
|
| S33.2XXA | Dislocation of coccyx | Use for acute traumatic dislocation of the coccyx. |
|
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 tailbone pain
Essential facts and insights about Tailbone Pain
Primary ICD-10-CM Codes for tailbone pain
Decision Criteria
clinical Criteria
- Chronic pain localized to coccyx without recent trauma.
Applicable To
- Coccydynia
- Chronic tailbone pain
Clinical Validation Requirements
- X-ray/MRI shows no fracture/dislocation
- Pain >3 months, no trauma
Code-Specific Risks
- Misclassification as low back pain (M54.5)
Coding Notes
- Ensure documentation specifies sacrococcygeal pain without lumbar involvement.
S33.2XXA - Dislocation of coccyx
Use for acute traumatic dislocation of the coccyx.
Applicable To
- Acute dislocation due to trauma
Excludes
- Chronic tailbone pain without trauma (M53.3)
Clinical Validation Requirements
- CT/MRI confirms dislocation
Coding Notes
Document the traumatic event leading to dislocation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Lumbosacral radiculopathy
M54.16Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Tailbone Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M53.3.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Use standardized templates for documentation., Ensure all relevant clinical details are recorded.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure documentation specifies coccygeal pain without lumbar involvement.
Impact
Incorrect code selection due to insufficient documentation.
Mitigation Strategy
Implement regular training for clinicians on documentation requirements.
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 Tailbone Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Tailbone Pain
Use these documentation templates to ensure complete and accurate documentation for Tailbone Pain. These templates include all required elements for proper coding and billing.
Chronic Tailbone Pain
Specialty: Physical TherapyRequired Elements
- Patient history
- Physical exam findings
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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