ICD-10 Coding for Sternal Pain(R07.2, M94.0)
Complete ICD-10-CM coding and documentation guide for Sternal Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sternal Pain
R07.1-R07.9Primary Range
Chest Pain
This range includes codes for various types of chest pain, including sternal 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 |
|---|---|---|---|
| R07.2 | Precordial Pain | Use for isolated sternal pain without confirmed etiology. |
|
| M94.0 | Chondrocostal Junction Syndrome [Tietze] | Use when sternal pain is due to costochondritis. |
|
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 sternal pain
Essential facts and insights about Sternal Pain
Primary ICD-10-CM Codes for sternal pain
Decision Criteria
clinical Criteria
- Pain localized to sternum with normal cardiac workup.
Applicable To
- Retrosternal pain
- Substernal discomfort
Excludes
- Cardiac chest pain
Clinical Validation Requirements
- Reproducible tenderness on palpation
- Normal EKG and troponin levels
Code-Specific Risks
- Misclassification as cardiac pain
Coding Notes
- Ensure documentation excludes cardiac causes.
M94.0 - Chondrocostal Junction Syndrome [Tietze]
Use when sternal pain is due to costochondritis.
Applicable To
- Costochondritis
Excludes
- Infectious arthritis
Clinical Validation Requirements
- Tenderness at costosternal junction
- Pain worsens with palpation
Coding Notes
Document specific site of tenderness.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chronic Pain
G89.29Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Sternal 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., Regulatory: Increases audit risk., Financial: Potential for denied claims.
Mitigation Strategy
Train staff on detailed documentation., Use templates for consistency.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Use R07.2 for more specific sternal pain coding.
Impact
Using unspecified codes like R07.9 increases audit risk.
Mitigation Strategy
Ensure documentation supports specific codes like R07.2.
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 Sternal Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sternal Pain
Use these documentation templates to ensure complete and accurate documentation for Sternal Pain. These templates include all required elements for proper coding and billing.
Acute Sternal Pain in Emergency Department
Specialty: Emergency MedicineRequired Elements
- History of Present Illness
- Physical Examination
- Diagnostic Tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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