Practice Management Alert

Following inclusion notes will keep your coding on track.

If your providers are in the habit of documenting that a patient has “chest pain,” you should encourage them to also document the exact location of the pain. That detail will be critical in choosing the proper ICD-10 code. Take a look at how you’ll need to adjust. 

Learn the Codes

Once ICD-10-CM is implemented after Oct. 1, 2015, you’ll need to know the meaning of “intercostal” if you want to choose the appropriate chest pain code. Here’s how the new code set options break down.

ICD-9-CM: 786.59, (Other chest pain)

• ICD-10-CM: 
• R07.82, (Intercostal pain)
• R07.89, (Other chest pain).

Scour the Documentation for Details

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).