ICD-10 Coding for Left Upper Extremity Pain(M79.622, G89.11)
Complete ICD-10-CM coding and documentation guide for Left Upper Extremity Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left Upper Extremity Pain
M79.60-M79.67Primary Range
Other and unspecified soft tissue disorders, not elsewhere classified
This range includes codes for pain in specific parts of the upper extremity, such as the upper arm and forearm.
Pain, not elsewhere classified
This range includes codes for acute and chronic pain conditions that may be used in conjunction with specific pain site codes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M79.622 | Pain in left upper arm | Use when pain is localized to the left upper arm without involvement of the shoulder or forearm. |
|
| G89.11 | Acute pain due to trauma | Use when acute pain is directly related to a recent traumatic event. |
|
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 upper extremity pain
Essential facts and insights about Left Upper Extremity Pain
Primary ICD-10-CM Codes for left upper extremity pain
Decision Criteria
clinical Criteria
- Pain localized to the left upper arm with no shoulder involvement.
documentation Criteria
- Detailed pain description including location, intensity, and aggravating factors.
Applicable To
- Localized pain in left upper arm
Excludes
- Pain in left shoulder (M25.512)
Clinical Validation Requirements
- Palpation tenderness in the left upper arm
- Pain scale documentation
- ROM limitations specific to the upper arm
Code-Specific Risks
- Risk of using this code when shoulder pain is present; ensure proper localization.
Coding Notes
- Ensure documentation clearly specifies the location and nature of the pain.
G89.11 - Acute pain due to trauma
Use when acute pain is directly related to a recent traumatic event.
Applicable To
- Acute post-traumatic pain
Excludes
- Chronic pain (G89.2-)
Clinical Validation Requirements
- Documentation of recent trauma or surgery
- Pain management as primary treatment focus
Coding Notes
Sequence first if pain management is the primary focus.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute pain due to trauma
G89.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left Upper Extremity 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: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Train staff on the importance of detailed documentation., Use templates that prompt for specific details.
Impact
Reimbursement: Potential for reduced reimbursement due to lack of specificity., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Decreased data quality and accuracy in patient records.
Mitigation Strategy
Use M79.622 for left upper arm pain to ensure specificity.
Impact
Audits may focus on whether the documentation supports the specific ICD-10 code used.
Mitigation Strategy
Ensure documentation includes detailed pain location and characteristics.
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 Upper Extremity Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left Upper Extremity Pain
Use these documentation templates to ensure complete and accurate documentation for Left Upper Extremity Pain. These templates include all required elements for proper coding and billing.
Chronic left upper arm pain in an orthopedic setting
Specialty: OrthopedicsRequired Elements
- Pain description
- ROM assessment
- Palpation findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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