ICD-10 Coding for Toe Pain(M79.675)
Complete ICD-10-CM coding and documentation guide for Toe Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Toe Pain
M79.67Primary Range
Other specified soft tissue disorders, not elsewhere classified
This range includes codes for pain in specific toes, such as left, right, bilateral, and unspecified.
Contusion of other specified part of foot
This range is used for traumatic injuries to the toes, which may present with pain.
Key Information: ICD-10 code for left toe pain
Essential facts and insights about Toe Pain
Primary ICD-10-CM Code for toe pain
Decision Criteria
clinical Criteria
- Pain localized to left toe(s) without trauma
documentation Criteria
- Explicit documentation of pain characteristics and absence of trauma
Applicable To
- Idiopathic toe pain
- Non-traumatic toe pain
Clinical Validation Requirements
- Documented pain in left toe(s) without trauma
- Negative imaging for fractures
- Normal uric acid levels if gout is suspected
Code-Specific Risks
- Risk of denial if trauma is not ruled out
- Inaccurate coding if laterality is not specified
Coding Notes
- Ensure documentation specifies laterality and rules out trauma or systemic causes.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Gout, left toe
M10.07Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Toe Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.675.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Train staff on importance of laterality in documentation., Use EHR prompts to ensure laterality is documented.
Impact
Reimbursement: May result in claim denials or reduced reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data for clinical and research purposes.
Mitigation Strategy
Always document and code the specific toe affected.
Impact
Failure to document laterality can lead to audit flags.
Mitigation Strategy
Implement EHR checks to ensure laterality is documented.
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 Toe Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Toe Pain
Use these documentation templates to ensure complete and accurate documentation for Toe Pain. These templates include all required elements for proper coding and billing.
Podiatry Evaluation for Toe Pain
Specialty: PodiatryRequired Elements
- Patient history
- Pain characteristics
- Physical examination findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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