What is the ICD-10 (International Classification of Diseases, 10th Revision) code for muscular chest pain?

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ICD-10 Code for Muscular Chest Pain

The ICD-10 code for muscular chest pain is M79.1 (Myalgia), though more specific codes may apply depending on the exact anatomical location and underlying cause.

Primary Coding Options

For general muscular chest pain without a more specific diagnosis, the following codes are most appropriate:

  • M79.1 - Myalgia: This is the most direct code for muscle pain, including chest wall muscle pain 1
  • R07.89 - Other chest pain: This can be used when the pain is localized to the chest but the specific musculoskeletal structure is not identified 1

More Specific Musculoskeletal Chest Pain Codes

When a more specific diagnosis has been established through clinical examination, use these codes:

  • M94.0 - Chondrocostal junction syndrome (Tietze syndrome): For musculoskeletal chest pain with localized inflammation at one or more joints between the rib and costal cartilage 1
  • M94.0 - Costochondritis: For inflammation of one or more ribs and/or cartilages (note: this shares the same code as Tietze syndrome in ICD-10) 1
  • S22.3XXA - Fracture of one rib, initial encounter: For rib injury-related pain 1
  • S22.41XA - Multiple fractures of ribs, initial encounter: For multiple rib injuries 1
  • S20.20XA - Contusion of thorax, unspecified, initial encounter: For sternal or chest wall contusion without fracture 1

Clinical Differentiation for Accurate Coding

The physical examination findings guide code selection 1:

  • Tenderness to palpation of costochondral joints → Use M94.0 for costochondritis/Tietze syndrome 1, 2
  • Reproducible pain with chest wall palpation without joint-specific tenderness → Use M79.1 for myalgia 1
  • History of trauma with localized tenderness → Use appropriate S22.X codes for rib or sternal injury 1
  • Intercostal muscle strain → Use S29.011A (strain of muscle and tendon of front wall of thorax, initial encounter) 1

Important Coding Considerations

Always code to the highest level of specificity available based on your clinical documentation 1. The ICD-10 system requires more detailed diagnostic information than ICD-9, so vague terms like "chest pain" should be avoided when a musculoskeletal etiology has been identified 3, 4.

Document the specific anatomical location and any associated findings (such as inflammation, trauma history, or joint involvement) to support your code selection 1.

Common Pitfall to Avoid

Do not use R07.9 (Chest pain, unspecified) or R07.89 (Other chest pain) when you have identified a specific musculoskeletal cause through examination 1. These non-specific codes should only be used when the etiology remains unclear after evaluation, as they provide less information for clinical use, research, and resource allocation 5.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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