ICD-10 Coding for Left Hip Joint Pain(M25.552)
Complete ICD-10-CM coding and documentation guide for Left Hip Joint Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Hip Joint Pain
Key Information: ICD-10 code for left hip joint pain
Essential facts and insights about Left Hip Joint Pain
Primary ICD-10-CM Code for left hip joint pain
Decision Criteria
clinical Criteria
- Pain localized to the left hip with supporting imaging
documentation Criteria
- Documentation must specify left hip and any chronicity
Applicable To
- Left coxalgia
Excludes
- Pain in right hip (M25.551)
- Bilateral hip pain (requires separate codes for each side)
Clinical Validation Requirements
- Patient reports localized pain in the left hip
- Imaging studies such as X-ray or MRI confirming pathology in the left hip
Code-Specific Risks
- Incorrectly coding bilateral pain as unilateral
- Failing to document laterality
Coding Notes
- Ensure documentation specifies the left hip and includes any chronicity if applicable.
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.
Unilateral primary osteoarthritis, left hip
M16.12Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Hip Joint Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M25.552.
Impact
Clinical: Leads to potential misdiagnosis or inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: May result in claim denials or reduced reimbursement.
Mitigation Strategy
Always specify the side of the body affected in documentation., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding can lead to denied claims or reduced reimbursement., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate data representation in patient records.
Mitigation Strategy
Use separate codes for each hip: M25.551 for right and M25.552 for left.
Impact
Failure to document laterality can lead to audit flags.
Mitigation Strategy
Implement mandatory fields in EHR for 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 Hip Joint Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Hip Joint Pain
Use these documentation templates to ensure complete and accurate documentation for Left Hip Joint Pain. These templates include all required elements for proper coding and billing.
Chronic Left Hip Pain Evaluation
Specialty: OrthopedicsRequired Elements
- Patient history including duration of pain
- Physical examination findings
- Imaging results
- Impact on ADLs
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Left Hip Joint Pain? Ask your questions below.