ICD-10 Coding for Left Side Rib Pain(R07.89, S22.32XA, M94.0)
Complete ICD-10-CM coding and documentation guide for Left Side Rib Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Side Rib Pain
R07.1-R07.9Primary Range
Pain in throat and chest
This range includes codes for various types of chest pain, including rib 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 |
|---|---|---|---|
| R07.89 | Other chest pain | Use for non-traumatic rib pain when no specific underlying condition like fracture or costochondritis is identified. |
|
| S22.32XA | Fracture of one rib, left side, initial encounter | Use for traumatic rib fractures confirmed by imaging. |
|
| M94.0 | Chondrocostal junction syndrome [Tietze] | Use when rib pain is due to costochondritis. |
|
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 side rib pain
Essential facts and insights about Left Side Rib Pain
Primary ICD-10-CM Codes for left side rib pain
Decision Criteria
clinical Criteria
- Non-traumatic, localized rib pain without specific underlying cause.
Clinical Validation Requirements
- Patient reports sharp, localized pain on the left side of the rib cage.
- Pain exacerbated by deep breathing or movement.
Code-Specific Risks
- Confusion with R07.81, which is no longer used for rib pain.
Coding Notes
- Ensure documentation specifies the location and nature of the pain.
S22.32XA - Fracture of one rib, left side, initial encounter
Use for traumatic rib fractures confirmed by imaging.
Applicable To
- Traumatic rib fracture
Excludes
- Non-traumatic rib pain (R07.89)
Clinical Validation Requirements
- Imaging confirms fracture of the left rib.
- Documented mechanism of injury, such as a fall.
Coding Notes
Ensure the 7th character is used to specify the encounter type.
M94.0 - Chondrocostal junction syndrome [Tietze]
Use when rib pain is due to costochondritis.
Applicable To
- Costochondritis
Excludes
- Rib fracture (S22.3-S22.4)
Clinical Validation Requirements
- Physical exam shows tenderness and swelling at the costochondral junction.
Coding Notes
Document the specific location and nature of the swelling and tenderness.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified abdominal pain
R10.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Side Rib Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R07.89.
Impact
Clinical: May lead to incorrect treatment plans., Regulatory: Non-compliance with ICD-10 coding rules., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Always include laterality in documentation., Use templates that prompt for specific details.
Impact
Reimbursement: May result in lower reimbursement due to lack of specificity., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the location and nature of the rib pain.
Impact
Risk of using unspecified codes when more specific codes are available.
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 Left Side Rib Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Side Rib Pain
Use these documentation templates to ensure complete and accurate documentation for Left Side Rib Pain. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Rib Pain
Specialty: Emergency MedicineRequired Elements
- Pain location and severity
- Onset and duration
- Associated symptoms
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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