ICD-10 Coding for Thigh Pain(M79.651, M79.652, M79.659)
Complete ICD-10-CM coding and documentation guide for Thigh Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Thigh 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 |
|---|---|---|---|
| M79.651 | Pain in right thigh | Use when the patient presents with localized pain in the right thigh without a specified underlying condition. |
|
| M79.652 | Pain in left thigh | Use when the patient presents with localized pain in the left thigh without a specified underlying condition. |
|
| M79.659 | Pain in unspecified thigh | Use when the documentation does not specify laterality of thigh pain. |
|
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 thigh pain
Essential facts and insights about Thigh Pain
Primary ICD-10-CM Codes for thigh pain
Decision Criteria
clinical Criteria
- Presence of localized pain in the right thigh
documentation Criteria
- Documented laterality and pain characteristics
Clinical Validation Requirements
- Documented tenderness on palpation
- Pain intensity and duration
- Imaging or physical exam findings
Code-Specific Risks
- Misclassification if laterality is not documented
Coding Notes
- Ensure laterality is documented to avoid unspecified code usage.
M79.652 - Pain in left thigh
Use when the patient presents with localized pain in the left thigh without a specified underlying condition.
Applicable To
- Localized pain in left thigh
Excludes
- Pain in hip (M25.55-)
- Pain in knee (M25.56-)
Clinical Validation Requirements
- Documented tenderness on palpation
- Pain intensity and duration
- Imaging or physical exam findings
Coding Notes
Ensure laterality is documented to avoid unspecified code usage.
M79.659 - Pain in unspecified thigh
Use when the documentation does not specify laterality of thigh pain.
Applicable To
- Generalized thigh pain without specified laterality
Excludes
- Pain in hip (M25.55-)
- Pain in knee (M25.56-)
Clinical Validation Requirements
- Generalized thigh pain documented without specific laterality
Coding Notes
Avoid using unspecified codes when laterality can be determined.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Trochanteric bursitis, unspecified hip
M70.60Trochanteric bursitis, left hip
M70.61Trochanteric bursitis, unspecified hip
M70.62Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Thigh Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.651.
Impact
Clinical: Leads to less precise treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials or reduced reimbursement.
Mitigation Strategy
Always specify right or left thigh in documentation.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement rates., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of patient records.
Mitigation Strategy
Ensure documentation specifies right or left thigh to use M79.651 or M79.652.
Impact
Reimbursement: Incorrect sequencing can affect DRG assignments., Compliance: Non-compliance with coding guidelines., Data Quality: Affects the accuracy of coding data.
Mitigation Strategy
Sequence G89 codes first if the encounter is primarily for pain management.
Impact
High risk of audit if unspecified codes are used when specific laterality is documented.
Mitigation Strategy
Ensure documentation includes laterality to use specific codes.
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 Thigh Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Thigh Pain
Use these documentation templates to ensure complete and accurate documentation for Thigh Pain. These templates include all required elements for proper coding and billing.
Chronic right thigh pain
Specialty: OrthopedicsRequired Elements
- Chief Complaint
- History of Present Illness
- Physical Examination
- Assessment and Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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