ICD-10 Coding for Leg Pain(M79.604, M79.605, M79.606)
Complete ICD-10-CM coding and documentation guide for Leg Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Leg Pain
M79.60-M79.66Primary Range
Pain in limb
This range includes specific codes for pain in different parts of the limb, including laterality.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M79.604 | Pain in right leg | Use when the patient presents with pain specifically in the right leg without a known underlying condition. |
|
| M79.605 | Pain in left leg | Use when the patient presents with pain specifically in the left leg without a known underlying condition. |
|
| M79.606 | Pain in unspecified leg | Use when the documentation does not specify which leg is affected. |
|
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 leg pain
Essential facts and insights about Leg Pain
Primary ICD-10-CM Codes for leg pain
Decision Criteria
clinical Criteria
- Presence of pain in the right leg with no other specified cause
Applicable To
- Right leg pain
Excludes
- Pain in right foot (M79.671)
Clinical Validation Requirements
- Documented laterality
- Specific location in the leg
Code-Specific Risks
- Incorrect use if laterality is not documented
Coding Notes
- Ensure laterality is documented to avoid unspecified coding.
M79.605 - Pain in left leg
Use when the patient presents with pain specifically in the left leg without a known underlying condition.
Applicable To
- Left leg pain
Excludes
- Pain in left foot (M79.672)
Clinical Validation Requirements
- Documented laterality
- Specific location in the leg
Coding Notes
Ensure laterality is documented to avoid unspecified coding.
M79.606 - Pain in unspecified leg
Use when the documentation does not specify which leg is affected.
Applicable To
- Leg pain, unspecified
Excludes
- Pain in foot, unspecified (M79.676)
Clinical Validation Requirements
- Lack of specific laterality documentation
Coding Notes
Avoid using this code if laterality is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified mononeuropathy of lower limb
G57.90Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Leg Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.604.
Impact
Clinical: Ambiguity in treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential for denied claims or reduced reimbursement
Mitigation Strategy
Train staff on importance of laterality, Use templates that prompt for laterality
Impact
Reimbursement: May lead to reduced reimbursement due to unspecified coding, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased data specificity and quality
Mitigation Strategy
Ensure documentation specifies laterality and use M79.604 or M79.605 accordingly.
Impact
Using unspecified codes when specific codes are available
Mitigation Strategy
Ensure documentation supports the most specific code available
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 Leg Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Leg Pain
Use these documentation templates to ensure complete and accurate documentation for Leg Pain. These templates include all required elements for proper coding and billing.
Chronic leg pain management
Specialty: Pain ManagementRequired Elements
- Location and laterality of pain
- Pain severity and character
- Aggravating and alleviating factors
- Associated symptoms
- Diagnostic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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