Cardiology Coding Alert

Following inclusion notes will keep your coding on track.

Once ICD-10-CM is implemented on Oct. 1, 2014, you’ll need to know the meaning of “intercostal” if you want to choose the appropriate chest pain code. Here’s how the new codeset options break down.

ICD-9-CM Code

• 786.59, Chest pain, other 
  

ICD-10-CM Codes

• R07.82, Intercostal pain
  
• R07.89, Other chest pain
  

Chest pain can refer to a number of descriptions related to discomfort in the patient’s chest. Note that this is not the same as breast pain, which is coded elsewhere.

ICD-9 coding rules: ICD-9 includes discomfort, pressure, and tightness in the chest under 786.59.

ICD-10 changes: ICD-10 divides your chest pain coding options among multiple codes. R07.82 is specific to pain designated as intercostal (between the ribs). The ICD-10 index, like ICD-9, points you to the code for “other chest pain” (R07.89) for discomfort, pressure, and tightness in chest.

Documentation: Your provider’s documentation should not need to change for you to choose the proper ICD-10 code if it allows you to distinguish between intercostal pain and the terms classified under “other” chest pain. Keep in mind, you’ll have separate codes for painful respiration (R07.1, Chest pain on breathing), precordial pain (R07.2, Precordial pain; R07.81, Pleurodynia), and unspecified chest pain (R07.9, Chest pain, unspecified).

Coder tips: Remember to read your inclusion notes. ICD-9 places “anterior chest wall” pain under 786.52 (Painful respiration). ICD-10 lists “Anterior chest-wall pain NOS [not otherwise specified]” under R07.89 (Other chest pain).