ICD-10 Coding for Pelvic Pain(R10.2, G89.29)
Complete ICD-10-CM coding and documentation guide for Pelvic Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pelvic Pain
R10-R19Primary Range
Symptoms and signs involving the digestive system and abdomen
Includes codes for abdominal and pelvic pain, which are primary for pelvic pain when no specific diagnosis is made.
Pain, not elsewhere classified
Includes chronic pain codes that may be used when pain management is the primary focus.
Noninflammatory disorders of female genital tract
Includes codes for specific conditions like endometriosis and dyspareunia, which may cause pelvic 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 |
|---|---|---|---|
| R10.2 | Pelvic and perineal pain | Use when pelvic pain is present without a specific diagnosis. |
|
| G89.29 | Other chronic pain | Use when chronic pain management is the primary focus. |
|
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 pelvic pain
Essential facts and insights about Pelvic Pain
Primary ICD-10-CM Codes for pelvic pain
Decision Criteria
clinical Criteria
- Pelvic pain with no identifiable cause after diagnostic tests.
coding Criteria
- Use R10.2 when no specific diagnosis is documented.
Applicable To
- Pain in pelvic region
- Perineal pain
Excludes
- Pain due to specific conditions like endometriosis (N80.1)
Clinical Validation Requirements
- Normal pelvic ultrasound
- Negative STI panel
Code-Specific Risks
- Risk of undercoding if specific etiology is identified but not documented.
Coding Notes
- Ensure documentation specifies that no specific cause was found if using R10.2.
G89.29 - Other chronic pain
Use when chronic pain management is the primary focus.
Applicable To
- Chronic pain not elsewhere classified
Excludes
- Acute pain (R52)
Clinical Validation Requirements
- Pain duration >3 months
- Failed NSAID trial
Coding Notes
Sequence first if encounter is for pain management.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other chronic pain
G89.29Differential 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 Pelvic Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.2.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use structured templates for documentation., Ensure thorough clinical evaluation and documentation.
Impact
Reimbursement: May lead to lower reimbursement if specific condition is not coded., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in health records.
Mitigation Strategy
Use the specific diagnosis code (e.g., N80.1 for endometriosis).
Impact
Risk of audit if symptom codes are used without ruling out specific conditions.
Mitigation Strategy
Ensure thorough diagnostic evaluation and documentation.
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 Pelvic Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pelvic Pain
Use these documentation templates to ensure complete and accurate documentation for Pelvic Pain. These templates include all required elements for proper coding and billing.
Chronic Pelvic Pain Evaluation
Specialty: GynecologyRequired Elements
- Pain location and intensity
- Duration and temporal pattern
- Associated symptoms
- Diagnostic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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