ICD-10 Coding for Pain in Left Thigh(M79.652, M54.5)
Complete ICD-10-CM coding and documentation guide for Pain in Left Thigh. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pain in Left Thigh
M79.60-M79.69Primary Range
Other soft tissue disorders, not elsewhere classified
This range includes codes for pain in specific body parts, including the left thigh.
Dorsalgia, including sciatica and low back pain
Relevant for cases where thigh pain is associated with sciatica or low back 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 |
|---|---|---|---|
| M79.652 | Pain in left thigh | Use when the pain is isolated to the left thigh without a known underlying cause. |
|
| M54.5 | Low back pain | Use when thigh pain is secondary to low back pain. |
|
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 pain in left thigh
Essential facts and insights about Pain in Left Thigh
Primary ICD-10-CM Codes for pain left thigh
Decision Criteria
clinical Criteria
- Pain localized to the left thigh without known cause
coding Criteria
- No other specific condition identified
Applicable To
- Localized pain in the left thigh
Excludes
- Pain due to known injury or condition (e.g., fracture, sprain)
Clinical Validation Requirements
- Clinical evaluation showing tenderness or pain localized to the left thigh
- Imaging studies ruling out other causes
Code-Specific Risks
- Risk of using a general code instead of this specific one
- Incorrectly coding when an underlying condition is known
Coding Notes
- Ensure documentation specifies the left thigh and rules out other causes.
M54.5 - Low back pain
Use when thigh pain is secondary to low back pain.
Applicable To
- Pain originating from the lower back
Excludes
- Pain due to specific spinal conditions
Clinical Validation Requirements
- Clinical evaluation indicating pain originating from the lumbar region
Coding Notes
Ensure documentation supports the back as the primary pain source.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other chronic pain
G89.29Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pain in Left Thigh to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M79.652.
Impact
Clinical: May lead to incorrect treatment plans, Regulatory: Non-compliance with ICD-10 coding standards, Financial: Potential claim denials or delays
Mitigation Strategy
Always document the side of the body affected, Use templates that prompt for laterality
Impact
Reimbursement: May lead to incorrect billing and reimbursement issues, Compliance: Non-compliance with coding guidelines, Data Quality: Decreased accuracy in medical records
Mitigation Strategy
Use M79.652 for specific left thigh pain
Impact
Omissions in specifying left or right can lead to audit findings.
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 Pain in Left Thigh, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pain in Left Thigh
Use these documentation templates to ensure complete and accurate documentation for Pain in Left Thigh. These templates include all required elements for proper coding and billing.
Chronic left thigh pain evaluation
Specialty: OrthopedicsRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Pain management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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