ICD-10 Coding for Right Rib Pain(R07.89, S22.31XA, M94.0)
Complete ICD-10-CM coding and documentation guide for Right Rib Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Rib Pain
R07.1-R07.9Primary Range
Pain in throat and chest
Includes codes for various types of chest pain, including rib 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 |
|---|---|---|---|
| R07.89 | Other chest pain | Use for non-traumatic rib pain without a specific diagnosis. |
|
| S22.31XA | Fracture of 1 right rib, initial encounter | Use when a fracture is confirmed by imaging. |
|
| M94.0 | Tietze syndrome | Use when swelling and inflammation are present at the costochondral junction. |
|
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 right rib pain
Essential facts and insights about Right Rib Pain
Primary ICD-10-CM Codes for right rib pain
Decision Criteria
clinical Criteria
- Pain localized to right rib cage without trauma or imaging abnormalities.
coding Criteria
- No specific underlying condition identified.
Applicable To
- Non-traumatic rib pain without confirmed etiology
Clinical Validation Requirements
- Pain localized to right rib cage without fracture, trauma, or systemic signs
Code-Specific Risks
- Risk of undercoding if specific cause is identified.
Coding Notes
- Ensure no trauma or fracture is documented before using this code.
S22.31XA - Fracture of 1 right rib, initial encounter
Use when a fracture is confirmed by imaging.
Applicable To
- Traumatic rib pain with confirmed fracture
Excludes
- Non-traumatic rib pain (R07.89)
Clinical Validation Requirements
- Positive imaging (X-ray/CT), point tenderness, history of trauma
Coding Notes
Sequence injury mechanism first, followed by rib fracture code.
M94.0 - Tietze syndrome
Use when swelling and inflammation are present at the costochondral junction.
Applicable To
- Inflammatory costochondritis
Excludes
- Non-inflammatory costochondritis (R07.81)
Clinical Validation Requirements
- Swelling at costochondral junction, reproducible pain on palpation
Coding Notes
Differentiate from non-inflammatory conditions by documenting swelling.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified fall, initial encounter
W19.XXXADifferential 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 Right Rib Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R07.89.
Impact
Clinical: May lead to incorrect treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure thorough documentation of trauma events., Use templates to guide documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of patient conditions.
Mitigation Strategy
Use R07.89 with a trauma code.
Impact
Reimbursement: Potential for claim denial due to incorrect coding., Compliance: Violation of coding standards., Data Quality: Misrepresentation of clinical data.
Mitigation Strategy
Default to R07.81 if swelling is absent.
Impact
Incomplete trauma documentation can lead to audit issues.
Mitigation Strategy
Ensure all trauma details are documented, including mechanism and associated injuries.
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 Right Rib Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Rib Pain
Use these documentation templates to ensure complete and accurate documentation for Right Rib Pain. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Traumatic Rib Pain
Specialty: Emergency MedicineRequired Elements
- History of present illness
- Imaging results
- Pain assessment
- Trauma details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Right Rib Pain? Ask your questions below.