ICD-10 Coding for Left Clavicle Pain(S42.022A, M25.512)
Complete ICD-10-CM coding and documentation guide for Left Clavicle Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Clavicle Pain
Pain in joint
Used for non-traumatic pain in the shoulder region, including the clavicle.
S42.0-S42.9Primary Range
Fracture of shoulder and upper arm
Primary range for traumatic injuries to the clavicle, including fractures.
Other specified disorders of bone
Used for non-traumatic bone disorders, potentially applicable to clavicle 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 |
|---|---|---|---|
| S42.022A | Displaced fracture of shaft of left clavicle, initial encounter for closed fracture | Use for initial encounters of traumatic fractures of the left clavicle. |
|
| M25.512 | Pain in left shoulder | Use for non-traumatic pain in the left clavicle region. |
|
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 left clavicle pain
Essential facts and insights about Left Clavicle Pain
Primary ICD-10-CM Codes for left clavicle pain
Decision Criteria
clinical Criteria
- Presence of fracture confirmed by imaging
Applicable To
- Acute traumatic fracture of left clavicle
Excludes
- Non-traumatic pain in clavicle
Clinical Validation Requirements
- X-ray or imaging confirmation of fracture
- Documented mechanism of injury
Code-Specific Risks
- Ensure imaging confirms fracture before coding.
Coding Notes
- Ensure documentation specifies the type of encounter (initial, subsequent, etc.).
M25.512 - Pain in left shoulder
Use for non-traumatic pain in the left clavicle region.
Applicable To
- Non-traumatic pain in left clavicular region
Excludes
- Fracture of clavicle
Clinical Validation Requirements
- Documented absence of trauma
- Pain duration and characteristics
Coding Notes
Consider potential referred pain from other regions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Activity codes (e.g., bicycle accident)
Y92.838Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Clavicle Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code S42.022A.
Impact
Clinical: Inadequate treatment planning, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Always document how the injury occurred, Include details in the initial assessment
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate patient records and data analysis.
Mitigation Strategy
Verify laterality in clinical documentation and imaging.
Impact
Coding the wrong side of the body can lead to audit issues.
Mitigation Strategy
Double-check documentation and imaging for correct laterality.
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 Left Clavicle Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Clavicle Pain
Use these documentation templates to ensure complete and accurate documentation for Left Clavicle Pain. These templates include all required elements for proper coding and billing.
Acute traumatic left clavicle fracture
Specialty: OrthopedicsRequired Elements
- Mechanism of injury
- Imaging results
- Neurovascular status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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