ICD-10 Coding for Pectoral Pain(R07.2, R07.89, G89.11)
Complete ICD-10-CM coding and documentation guide for Pectoral Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pectoral Pain
R07.1-R07.9Primary Range
Chest Pain Codes
This range includes various types of chest pain, including pectoral pain, which is often coded as R07.89 for anterior chest wall pain.
Pain, not elsewhere classified
These codes are used for pain management scenarios, particularly when pain is the primary focus of treatment.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R07.2 | Precordial pain | Use when pain is localized to the cardiac region and associated with exertion or cardiac symptoms. |
|
| R07.89 | Other chest pain | Use for non-cardiac musculoskeletal pain, especially when specified as anterior chest wall pain. |
|
| G89.11 | Acute pain due to trauma | Use when pain management is the primary reason for the encounter and is due to recent trauma. |
|
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 pectoral pain
Essential facts and insights about Pectoral Pain
Primary ICD-10-CM Codes for pectoral pain
Decision Criteria
clinical Criteria
- Pain localized to the cardiac region with exertion
Applicable To
- Pain localized to the cardiac region
Excludes
- Angina pectoris (I20.-)
Clinical Validation Requirements
- Pain worsens with exertion
- Radiation to left arm/jaw
- ECG changes
Code-Specific Risks
- Misclassification as general chest pain
Coding Notes
- Ensure documentation specifies precordial location and associated cardiac symptoms.
R07.89 - Other chest pain
Use for non-cardiac musculoskeletal pain, especially when specified as anterior chest wall pain.
Applicable To
- Anterior chest wall pain
Excludes
- Costochondritis (R07.82)
Clinical Validation Requirements
- Reproducible tenderness
- Pain with arm movement
- Normal cardiac markers
Coding Notes
Documentation should specify 'anterior chest wall pain' to differentiate from general chest pain.
G89.11 - Acute pain due to trauma
Use when pain management is the primary reason for the encounter and is due to recent trauma.
Applicable To
- Acute post-traumatic pain
Excludes
- Chronic pain syndrome (G89.4)
Clinical Validation Requirements
- Documented trauma history
- Acute onset (<3 months)
Coding Notes
Ensure trauma is documented as the cause of pain.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Pectoral Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R07.2.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Increases risk of non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Train staff on the importance of detailed pain documentation., Use templates that prompt for specific pain details.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit and non-compliance., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the type and location of chest pain to use the most specific code.
Impact
High risk of audit when unspecified chest pain codes are used without detailed documentation.
Mitigation Strategy
Ensure documentation specifies the exact nature and location of chest pain.
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 Pectoral Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pectoral Pain
Use these documentation templates to ensure complete and accurate documentation for Pectoral Pain. These templates include all required elements for proper coding and billing.
Emergency Department Evaluation for Chest Pain
Specialty: Emergency MedicineRequired Elements
- Location of pain
- Duration and onset
- Associated symptoms
- Relevant history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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