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ICD-10 Coding for Left Humerus Pain(M79.622, S42.202A)

Complete ICD-10-CM coding and documentation guide for Left Humerus Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Pain in Left Upper ArmLeft Arm Pain

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Related ICD-10 Code Ranges

Complete code families applicable to Left Humerus Pain

M79.6Primary Range

Pain in limb

This range includes codes for pain in specific limbs, including the upper arm.

S42.2

Fracture of upper end of humerus

This range is relevant if the pain is due to a fracture of the humerus.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
M79.622Pain in left upper armUse when the patient presents with non-specific pain in the left upper arm without confirmed fracture.
  • Documented pain localized to the left upper arm
  • No evidence of fracture on imaging
S42.202ANondisplaced fracture of upper end of left humerus, initial encounterUse when imaging confirms a nondisplaced fracture of the left humerus.
  • Imaging confirmation of fracture
  • Documented trauma history

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 humerus pain

Essential facts and insights about Left Humerus Pain

The ICD-10 code for left humerus pain is M79.622, which specifies pain in the left upper arm.

Primary ICD-10-CM Codes for left humerus pain

M79.622
Pain in left upper arm
Billable Code

Decision Criteria

clinical Criteria

  • Pain localized to the upper arm with no fracture

Applicable To

  • Localized pain in the left humerus

Excludes

Clinical Validation Requirements

  • Documented pain localized to the left upper arm
  • No evidence of fracture on imaging

Code-Specific Risks

  • Confusion with shoulder pain codes
  • Incorrect use if fracture is present

Coding Notes

  • Ensure documentation specifies 'upper arm' to avoid confusion with general arm pain codes.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Acute pain due to trauma

G89.11
Use when pain management is the primary focus of the encounter.

Fall from same level, initial encounter

W19.XXXA
Use to describe the external cause of the fracture.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Pain in left shoulder

M25.512
Use if pain is localized to the shoulder joint rather than the upper arm.

Pain in left upper arm

M79.622
Use M79.622 if no fracture is present.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Left Humerus Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.622.

Impact

Clinical: Leads to inaccurate patient records., Regulatory: May trigger audits due to coding discrepancies., Financial: Potential for claim denials or reduced reimbursement.

Mitigation Strategy

Train staff to recognize and document specific pain locations., Use decision support tools to guide code selection.

Impact

Reimbursement: Incorrect coding can lead to claim denials., Compliance: May result in audits if codes do not match documentation., Data Quality: Affects accuracy of patient records and data analysis.

Mitigation Strategy

Ensure documentation specifies 'upper arm' to differentiate from shoulder pain.

Impact

Audits may focus on ensuring codes match the documented location of pain.

Mitigation Strategy

Implement regular training and audits of documentation practices.

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 Humerus Pain, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Left Humerus Pain

Use these documentation templates to ensure complete and accurate documentation for Left Humerus Pain. These templates include all required elements for proper coding and billing.

Patient with non-specific left upper arm pain

Specialty: Orthopedics

Required Elements

  • Pain location
  • Duration
  • Severity
  • Exclusion of fracture

Example Documentation

Patient reports sharp pain in the left upper arm, onset 3 days ago, rated 6/10, no trauma history, X-ray negative for fracture.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Left arm pain.
Good Documentation Example
Sharp pain localized to the left upper arm, onset 3 days ago, rated 6/10, X-ray negative for fracture.
Explanation
The good example provides specific location, duration, severity, and imaging results, which are necessary for accurate coding.

Need help with ICD-10 coding for Left Humerus Pain? Ask your questions below.

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