ICD-10 Coding for Chest Pain(R07.1, R07.2, R07.89)
Complete ICD-10-CM coding and documentation guide for Chest Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chest Pain
R07.1-R07.9Primary Range
Pain in throat and chest
This range covers various types of chest pain, including unspecified and specific types like precordial pain.
Ischemic heart diseases
This range includes codes for angina and myocardial infarction, which are important differential diagnoses for chest 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 |
|---|---|---|---|
| R07.1 | Chest pain on breathing | Use when chest pain is specifically worsened by breathing. |
|
| R07.2 | Precordial pain | Use for pain localized to the precordial area. |
|
| R07.89 | Other chest pain | Use for specified types of chest pain not covered elsewhere. |
|
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 chest pain
Essential facts and insights about Chest Pain
Primary ICD-10-CM Codes for chest pain
Decision Criteria
clinical Criteria
- Pain worsens with deep breaths or coughing.
Applicable To
- Pleuritic pain
Excludes
- Pain due to angina (I20.9)
Clinical Validation Requirements
- Pain reproducible with respiration
- CXR showing pleural effusion
Code-Specific Risks
- Misclassification if not clearly documented as pleuritic.
Coding Notes
- Ensure documentation specifies the respiratory nature of the pain.
R07.2 - Precordial pain
Use for pain localized to the precordial area.
Applicable To
- Pain in the heart region
Excludes
- Angina pectoris (I20.-)
Clinical Validation Requirements
- Substernal pressure radiating to jaw or arm
Coding Notes
Document specific location and radiation of pain.
R07.89 - Other chest pain
Use for specified types of chest pain not covered elsewhere.
Applicable To
- Anterior chest wall pain
Excludes
- Cardiac-related pain (I20-I25)
Clinical Validation Requirements
- Localized tenderness, no cardiac biomarkers
Coding Notes
Ensure documentation specifies the type and location of pain.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chest Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R07.1.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Increased risk of audit failure., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Train clinicians on detailed documentation., Use structured templates for HPI.
Impact
Reimbursement: Lower DRG weights for unspecified codes., Compliance: Potential for audit issues due to lack of specificity., Data Quality: Decreased accuracy in clinical data.
Mitigation Strategy
Ensure documentation specifies the type and location of chest pain.
Impact
Frequent use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation supports the most specific code possible.
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 Chest Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chest Pain
Use these documentation templates to ensure complete and accurate documentation for Chest Pain. These templates include all required elements for proper coding and billing.
Emergency Department presentation with chest pain
Specialty: Emergency MedicineRequired Elements
- Location of pain
- Quality and severity
- Radiation
- Timing and duration
- Aggravating and relieving factors
- Associated symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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