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What is the ICD-10 code for Midsternal chest pain?

ICD-10 code R07.89 for Other chest pain is a medical classification as listed by WHO under the range – Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified.

What is the code for Substernal chest pain?

Coding for Chest Pain April 26, 2010 Coding for Chest Pain For The Record Vol.22 No.8 P.27 A common reason for seeking emergency treatment is chest pain. Although the underlying cause may not be cardiac related, the patient should be seen immediately by a physician if the pain continues and radiates to the neck, shoulder, arm, or jaw.

• If the pain is due to a myocardial infarction, treatment within the first six hours may help prevent further damage to the heart muscle.
• Pain in any part of the chest may include problems with the heart, lungs, esophagus, muscle, bone, or skin.
• Chest discomfort or pain that begins or gets worse with exercise, stress, or eating a large meal and goes away with rest may be a warning sign of heart disease.

Other symptoms accompanying cardiac-related chest pain may include chest pressure, fullness, or tightness; a crushing or squeezing pain that radiates to the back, neck, jaw, shoulders, or arms, more commonly affecting the left arm and shoulder; the feeling of a heavy weight on the chest; pain that lasts more than a few minutes then goes away and returns or varies in intensity; shortness of breath; sweating; dizziness or lightheadedness; nausea or vomiting; sudden weakness; and a fast, slow, or irregular heartbeat.

Other symptoms accompanying noncardiac-related chest pain may include a burning sensation behind the sternum, a sour taste in the mouth, difficulty swallowing, fluctuations in pain intensity when there is a change in body position, pain intensification with deep breathing and coughing, and tenderness when pressure is applied to the chest.

Chest pain is classified to ICD-9-CM code 786.50, which may change depending on the exact location, with midsternal or substernal chest pain coded to 786.51 and chest wall or anterior chest wall pain coded to 786.52. If the pain is described as atypical, musculoskeletal, or noncardiac with no further information on the underlying cause, then code 786.59 is assigned.

• The documentation of chest discomfort, pressure, and tightness is also classified to this code.
• These chest pain codes are symptom codes.
• According to coding guidelines, assign a code for the related definitive diagnosis if one has been established by the physician instead of a code for the symptom.
• Some common cardiac-related causes of chest pain may include the following: • Acute myocardial infarction (category 410) occurs when the coronary arteries are blocked causing damage to the heart muscle.

• Angina occurs when there is plaque buildup in the coronary arteries that temporarily restricts blood flow, usually during exertion. Stable angina (413.9) occurs repetitively and predictably with exercise and goes away with rest. Unstable angina (411.1) is unusual or unpredictable pain not completely relieved with rest or pain that occurs at rest.

Aortic dissection (441.00 to 441.03) is a tear in the inner lining of the aorta and may cause massive internal bleeding. • Coronary spasm (413.9), which causes Prinzmetal angina (413.1), results in a temporary stop in blood flow. • Pericarditis (category 420 or 423) is inflammation of the sac surrounding the heart.

• Mitral valve prolapsed (424.0) is a heart valve abnormality. • Myocarditis (category 422 or 429.0) is an inflammation of the heart. • Hypertrophic cardiomyopathy (425.1 or 425.4).

• The following are some common digestive causes of chest pain:
• • heartburn (787.1);
• • gastroesophageal reflux (530.81);

• esophagitis (530.10 to 530.19);

1. • esophageal spasm (530.5);
2. • hiatal hernia (553.3);
3. • achalasia (530.0);
4. • perforated viscus (799.89);
5. • cholecystitis, cholelithiasis (categories 574 and 575); and

• pancreatitis (577.0 or 577.1). Common respiratory causes of chest pain include the following: • pulmonary embolism (415.11 to 415.19); • pleurisy (511.0); • spontaneous pneumothorax (512.8); and • pulmonary hypertension (416.8). Some common musculoskeletal causes of chest pain may include costochondritis or Tietze’s disease (733.6), fibromyalgia (729.1), and injured ribs or pinched nerves.

1. Some other causes of chest pain may include a panic attack (300.01), shingles (category 053), and cocaine-induced chest pain (970.8 + 786.50), which should be coded as a poisoning since the patient had a reaction to a drug that was not prescribed.
2. Coding and sequencing for chest pain are dependent on the physician documentation in the medical record and application of the Official Coding Guidelines for inpatient care.

Also, use specific AHA Coding Clinic for ICD-9-CM and American Medical Association CPT Assistant references to ensure complete and accurate coding. — This information was prepared by Audrey Howard, RHIA, of 3M Consulting Services.3M Consulting Services is a business of 3M Health Information Systems, a supplier of coding and classification systems to more than 5,000 healthcare providers.

• The company and its representatives do not assume any responsibility for reimbursement decisions or claims denials made by providers or payers as the result of the misuse of this coding information.
• More information about 3M Health Information Systems is available at www.3mhis.com or by calling 800-367-2447.

: Coding for Chest Pain

What is the ICD-10 code for sternal strain?

ICD-10 code: S23.4 Sprain and strain of ribs and sternum.

What causes sternum chest pain?

The sternum, also known as the breastbone, is the long, flat bone in the middle of your chest. You can have pain in this area because of infection, inflammation, injury, or the breakdown of cartilage affecting the sternum itself. Problems with nearby organs like the heart, lungs, and esophagus can also cause pain in this area.

• This includes a heart attack, pleurisy (a lung inflammation), and acid reflux.
• Usually, if the pain is in the actual sternum, you’ll have sharp pain when you push in the middle of your chest.
• But because the symptoms of chest bone pain are so similar to other causes of chest pain, you might need to have tests to check for heart attack and other serious conditions.

If your problem is just with your actual sternum, you may feel better with rest, gentle stretching, and anti-inflammatory medications. But if there are other issues, you might need prescription medications, joint injections, or surgery.

What is sternal vs Substernal chest pain?

Causes of Sternal Pain –

• Sternum pain is usually caused by problems with the muscles and bones near the sternum and not the sternum itself.
• Pain felt just behind or below the sternum is called substernal pain and is sometimes caused by gastrointestinal problems,
• Some of the most common causes of sternum and substernal pain are:
• For more detail on specific causes, see lists below.

What is Substernal chest?

A condition in which the thyroid gland (located in the lower neck) or masses inside the gland grow downward into the upper chest is called substernal thyroid or substernal goiter. In many cases this growth can be slow, enlarging over a period of years and gradually pressing on structures such as the esophagus.

What is the ICD-10 for chest pain pain?

ICD-10 Code: R07.9 – Chest Pain, Unspecified – ICD-Code R07.9 is a billable ICD-10 code used for healthcare diagnosis reimbursement of Chest Pain, Unspecified. Its corresponding ICD-9 code is 786.5. Billable: Yes ICD-9 Code Transition: 786.5 Code R07.9 is the diagnosis code used for Chest Pain, Unspecified.

Chest pain Chest pain on exertion Chest pain, localized Exertional chest pain Localized chest pain

What is the ICD 11 code for chest pain?

ME81 Musculoskeletal chest pain – ICD-11 MMS.

Can sternum pain feel like heart pain?

Costochondritis (kos-toe-kon-DRY-tis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.

What is chest syndrome ICD-10?

ICD-10 code D57.01 for Hb-SS disease with acute chest syndrome is a medical classification as listed by WHO under the range – Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism.

Can stress cause sternum pain?

Stress can trigger the release of hormones, like adrenaline and cortisol. This can increase your heart rate and blood pressure as well as make breathing difficult. Your throat may also constrict and your chest muscles might tighten. All of these can cause pain in the chest.

What is sternum pain syndrome?

Costochondritis is the medical term for inflammation of the cartilage that joins your ribs to your breastbone (sternum). This area is known as the costochondral joint. Cartilage is tough but flexible connective tissue found throughout the body, including in the joints between bones.

What is anterior chest wall pain?

Most Common	Less Common
As a result of direct Injury or trauma to chest	Stress fractures
Costochondritis	Tietze’s syndrome
Slipped Rib Syndrome or lower rib pain syndromes	Xiphoidalgia
Pain radiating from thoracic spine or costovertebral joints	Spontaneous sternoclavicular subluxation
Intercostal muscle strain or pulled chest muscle
Sternalis syndrome

Costochondritis refer to Inflammation of the cartilage junctions of the sternum and ribs typically felt at the costosternal and costochondral joints. It is a relatively common condition seen in adult and patients who develop pain and tenderness at the front of the chest.

• It’s felt over the affected cartilage segments in multiple areas, usually on one, or occasionally both sides of the sternum.
• The most common sites of pain are the anterior cartilage segments of the 2th to 5th ribs at the front of the chest near where the ribs join the breastbone.
• This pain increases with activity, moving or twisting or when taking deep breaths.

Conversely, it decreases as movement stops or with quiet breathing. The reproducible tenderness but without swelling you feel when you press on the sternal and rib joints (costosternal and costochondral junctions respectively) is a constant feature of costochondritis.

Without this tenderness, a diagnosis of costochondritis is unlikely. The cause is unknown but may be associated with unusual or excessive physical activity, minor trauma particularly repetitive and/or excessive over of use of arms. Occasionally, it can follow a viral infection or rarely a bacterial or fungal infection in patients prone to such infections.

There also appears to be a relationship between chest wall deformities and costochondritis and certainly younger patients with pectus excavatum and carinatum complain of cheat wall pain though it’s difficult ascertain whether this is costochondritis, idiopathic chest wall pain (chest pain in children without an obvious cause) or chest wall pain caused by the anatomical deformity associated with pectus. Typical location of pain and tenderness noted in Costochondritis Tietze syndrome is often confused with costochondritis but is rarer and importantly associated with sudden chest pain and localised swelling at junction of the ribs and breastbone. It usually affects the junctions at the 2nd and 3rd ribs.

1. The swelling may last for several months and often radiates to the arms and shoulders.
2. The cause is unknown.
3. For Lower rib pain syndromes,
4. See Slipped rib syndrome,
5. Pain originating from the thoracic spine and specifically from the ‘spinal-rib complex’ is common.
6. The pain experienced in the front or side of the chest is described as referred pain and may arise from the posterior thoracic spinal structures including the intervertebral discs and facets.

Costotransverse disorders or costovertebral joint dysfunction are disorders affecting or involving specifically the costotransverse and costovertebral joints and ligaments which are felt to be related to pain experienced in the thorax. See other associated problems,

Muscle strain or a ‘pulled muscle’ refers to muscle overstretching leading to a partial or complete tear and can occur in any muscle. Muscles affected tend to be in ones that cross two joints; exposed to sudden explosive action, such as sprinting and the hamstrings; or following periods of overtraining.

In the chest, sudden twisting or movement ‘at the torso’ particularly against resistance can lead to an intercostal muscle strain, The diagnosis is a clinical one, that is relying on the clinical history and examination as the muscle and injury to it, is hard to ‘see’ using radiology (MRI and ultrasound) and so grades of muscle strain are hard to allocate to intercostal muscle strain.

Grade	Features
Grade 1	Mild damage to individual muscle fibres (less than 5% of fibres) that causes minimal loss of strength and motion.
Grade 2	More extensive damage with more muscle fibres involved. However, the muscle is not completely ruptured. These injuries present with significant loss of strength and motion.
Grade 3	Complete rupture of a muscle or tendon. These can present with a palpable defect in the muscle or tendon. However, swelling in the area may make this difficult to appreciate.

Activities and Sports that may cause chest wall muscle strain:

Intercostal muscle	Pectoralis muscle	Latissimus dorsi	Serratus muscle
Weight training (side to side against resistance)	Weight training (bench press)	Weight training (bench press)	Weight training (heavy weights)
Heavy lifting with side bending, twisting or turning	Heavy lifting from front to chest height	Heavy lifting with upper body	Repetitive motions against resistance
Bowling	Rugby	Climbing	Swimming
Cricket, Baseball (bowling, throwing)	Skiing	Cricket, baseball & throwing activities	Tennis
Rowing	Wrestling	Rowing
Tennis	Hockey	Tennis
Hockey	Parachuting

Large chest wall and abdominal muscles Larger chest wall muscle groups can also be strained. The Pectoralis major muscle is a large muscle at the front of the chest. It used to rotate the arm inwards, pull a horizontal arm across the body, pull the arm from above the head down and pull the arm from the side upwards.

• Pectoralis Major strain can happen during vigorous sports activity classically weight training.
• Its weak point is where the pectoralis or pec muscle tendon attaches to the upper humerus (arm bone) though rarely its tendinous insertion to the upper ribs and sternum can also tear.
• Symptoms of a pec major sprain include a sudden sharp pain at the front of the upper arm, near the shoulder and depending on the grade of muscle strain, swelling (haematoma) of the front of the shoulder and upper arm.

Tests which reproduce pain help confirm the diagnosis and include getting the patient to pull their arm across the front of the chest or rotate it inwards against resistance. A visible gap or lump in the muscle may appear. The Latissimus dorsi muscle or ‘lats’ is another large, flat “V” shaped muscle of the torso.

1. It spans the width of your back and helps control the movement of your shoulders and is often referred as the “climbers” muscle.
2. With a Latissimus dorsi strain, you might feel pain in your low back, mid-to-upper back, along the base of your scapula or shoulder blade, or in the back of the shoulder.
3. You may even feel pain along the inside of the arm, all the way down to your fingers.

The Serratus anterior muscle spans the upper eight or nine ribs. This muscle helps you rotate or move your scapula or shoulder blade forward and up. Sometimes it’s referred to as the “boxer’s muscle,” since it’s responsible for the movement of the scapula when a person throws a punch.

• Serratus muscle strain typically from repetitive activities such as tennis results in pain in the chest, back, or arm and can make it difficult to lift your arm overhead or have a normal range of motion with the arm and shoulder.
• It can also be associated with arm or finger pain, difficulty with deep breathing and shoulder blade pain.

Serratus anterior myofascial pain syndrome is part of a broader set of conditions known as myofascial pain syndromes. Myofascial pain is a process in which pain and dysfunction are related to the development and persistence of focal sensitive areas or trigger points, that when pressed can cause referred pain (pain felt elsewhere).

Though not strictly a chest wall muscle, the upper Rectus abdominis muscle and External oblique muscle can also be strained, torn or even ruptured leading to pain, which depending on the site of injury can lead to lower chest wall pain and pain when pain twisting from a seated position or when rising from a bed particularly if flexing (bending).

Sternalis syndrome presents with anterior chest pain associated with localised tenderness over the body of the sternum or overlying sternalis muscle; palpation often causes radiation of pain bilaterally. It is an unusual cause of anterior chest wall pain as it appears to be associated with an accessory muscle, the sternalis muscle which is present in only around 5-10% of people and sit in a variable position in front of the main pectoralis muscle.

1. When symptomatic, it is another form of myofascial pain syndrome.
2. Though uncommon, Stress fractures of the ribs can be seen following repetitive activity or in increased loading.
3. They can occur in the first rib, and less commonly other ribs particularly in those engaged in repetitive forceful sports such as rowers or weightlifters.

The pain which is localised to the area with associated tenderness may start gradually but ends to worsen and is only eased with rest and or avoidance of the repetitive activity. Xiphoid process pain ( xiphoidalgia ) occurs for varying reasons but is often related to minor trauma to the area or over exercise (such as abdominal crunches). Stress fracture of right first rib (red ring) in a body builder