ICD 10 code for chest pain - R07.9


Chest pain, unspecified. R07.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

R07.9 - Chest pain, unspecified

Chest pain 

 Other (anterior) R07.89 Unspecified R07.9
R07.1 Chest pain on breathing
R07.89 Other chest pain

ICD-9: 786.50

R07 Excludes1: epidemic myalgia (B33.0)
Excludes2: jaw pain R68.84


Chest Pain (ICD-9-CM 411.1, 413.1, 413.9, 786.50 to 786.59 Range)

I20.0 Unstable angina
I20.1 Angina pectoris with documented spasm
I20.8 Other forms of angina pectoris
I20.9 Angina pectoris, unspecified
R07.1 Chest pain on breathing
R07.2 Precordial pain
R07.81 Pleurodynia
R07.82 Intercostal pain
R07.89 Other chest pain
R07.9* Chest pain, unspecified


Pain in breast (N64.4)

R00-R99

Notes: This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded. Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.

The conditions and signs or symptoms included in categories R00-R94 consist of:

(a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;

(b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;

(c) provisional diagnosis in a patient who failed to return for further investigation or care;

(d) cases referred elsewhere for investigation or treatment before the diagnosis was made;

(e) cases in which a more precise diagnosis was not available for any other reason;

(f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

Excludes: abnormal findings on antenatal screening of mother (O28.-)
certain conditions originating in the perinatal period (P04-P96)
signs and symptoms classified in the body system chapters
signs and symptoms of breast (N63, N64.5)


Chest pain due to cocaine intoxication 

This is a poisoning. Poisoning is sequenced as the principal diagnosis, 986.5, poisoning by other central nervous system depressants and anesthetics, surface (topical) and infiltration anesthetics.


Midsternal chest pain 

Midsternal chest pain is assigned code 786.51

Noncardiac chest pain in emergency room 

Chest pain of gastrointestinal origin, in a patient with a history of gastroesophageal reflux, is assigned code 789.06, abdominal pain, epigastric. Assign code 530.81, gastroesophageal reflux, if the physician documented that chest pain was due to gastroesophageal reflux.


Observation and evaluation for suspected cardiovascular conditions 

Code V71.1 would only be assigned when a suspected cardiovascular condition is ruled out and no symptoms for the suspected condition are present. If a symptom is present, the code for the symptom is assigned and not a code from category V71.


ICD-9 Description ICD-9   VS  ICD-10 Description ICD-10

786.50 Chest pain, unspecified R07.9 Chest pain, unspecified
786.59 Other chest pain R07.82 Intercostal pain

• For example, if a patient presents with intermittent chest pain, document the symptom as “intermittent chest pain” or “chest pain, rule out angina” and use the ICD-9 code for unspecified chest pain (786.50).

• If you then do a stress test which is abnormal, you can document the more definitive diagnosis of angina (ICD-9 code 413.9), but if you rule out angina, then the diagnosis stays as the symptom of chest pain.

• Once you make a definitive diagnosis, you should not submit the ICD-9 code for a symptom that relates to that diagnosis. In the example above, a patient with angina who has chest pain would only have the ICD-9 code for angina submitted with the claim.

Other than Technical information here is some useful tips to get to know about chest pain and not to fear.


Common Codes

Clinical Documentation Tips

• Abnormalities of Heart Rhythm

• Atrial Fibrillation and Flutter

• Cardiac Arrhythmias (Other)

• Chest Pain

• Heart Failure

• Hypertension

• Nonrheumatic Valve Disorders

• Selected Atherosclerosis, Ischemia, and Infarction

• Syncope and Collapse

Chest Pain (ICD-9-CM 411.1, 413.1, 413.9, 786.50 to 786.59 Range)

I20.0 Unstable angina
I20.1 Angina pectoris with documented spasm
I20.8 Other forms of angina pectoris
I20.9 Angina pectoris, unspecified
R07.1 Chest pain on breathing
R07.2 Precordial pain
R07.81 Pleurodynia
R07.82 Intercostal pain
R07.89 Other chest pain
R07.9* Chest pain, unspecified

Scenario 3: Chest Pain

Scenario Details

Chief Complaint

• Chest pain.

History

• 70 year old female patient presents with complaints of chest pain that awoke her from sleep last night. Patient describes the pain as midsternal “tight, squeezing” and pressure in the epigastric region. Patient reports that the pain was accompanied by diaphoresis and lasted approximately 5-10 minutes before spontaneously resolving. Patient states she tried sitting up, walking, and taking some liquid antacid but experienced no relief with these measures. Denies change in diet, or any unusual foods yesterday.

• She also reported experiencing some intermittent attacks of chest pain and tightness approximately 2-3 times over the last six months, that previous episodes were shorter in duration with less severe pain, and usually occurred when she was “emotional” or “tired”. Pain with prior episodes was relieved by rest.

• Recent widowed status – husband died seven months ago; states increasing anxiety and difficulty sleeping.

• Medical history significant for hypertension and hyperlipidemia. Negative for stroke, myocardial infarction, bleeding disorders, GERD, anxiety, and depression.

• Social history: Nonsmoker, occasional social drinking, denies illicit drug use. She only engages in sedentary activities at this time.

• Family history: Father died of heart attack at age 50, mother is 95 years old and in good health, two siblings both in good health, otherwise negative family history.

• Influenza and pneumococcal immunizations up to date. No known allergies.

• Current medications: Hydrochlorothiazide and atorvastatin; Denies OTC medications.

• Comprehensive review of systems negative for significant symptoms.

Exam

• T: afebrile, P 90, R 16, BP 160/94 (sitting) 128/78 (lying), 132/82 (standing) Ht: 68in. Wt: 201 lbs BMI: 30.6 (obese)

• HEENT & NECK: normal to exam.

• CHEST: Clear to exam

• CV: RRR without murmur, gallop, or rub, No JVD. Carotids clear bilaterally.

• PERIPHERAL VASCULAR: Skin warm and dry with good pulses to all extremities.

No edema bilaterally.

• ABDOMEN: normal to exam.

• NEURO: Patient A&Ox3. Moves all extremities well.

Assessment and Plan

• Worsening neuropathy with foot ulcer and slow healing shin wound.

• Will debride and treat wounds here and refer to Wound Care Center for ongoing care and management.

• Discussed importance of foot care, and the need to routinely inspect lower legs and bottoms of feet because of the bilateral peripheral neuropathy.

• Counseled patient about the importance of tight, stable glycemic control to slow the progression of neuropathy and nephropathy; advised to keep a log of his blood sugars for two weeks for our review.


Simple home remedies to treat chest pain

Unlike the earlier days, the food habit and lifestyle of the people have completely changed therefore they are supposed to face many health issues. Chest pain is one of the common problems which are experienced by many people. Generally many people use to think that they will be having heart problem whenever they are feeling pain in the chest. Actually it is a common misconception that many people use to have. Whenever people feel chest pain, it does not mean they will be having some heart related problems. There are different types of chest pain due to different reasons. Therefore people should not get panic when they feel chest pain. But it is always recommended to approach a doctor and take a test. This is to make sure the chest pain that people have is not a symptom of heart attack.

Approaching a doctor immediately may save them from any serious consequences. But, most of the times, people will be having a normal chest pain and they will get panic and imagine so many things. As it is mentioned already, there are many reasons for chest pain and you may feel it due to gastritis, acidity, anxiety, cold, coughing and also because of smoking. People have to understand this and they should be relaxed. However, the following are some of the home remedies which can give relief from the chest pain which is caused by the above mentioned reasons.

Ginger:
This is one of the common home remedy which is preferred by most of the people and also recommended by the medical experts. Ginger has the ability to reduce the chest pain which occurs due to acidity as well as cold or flu. If you prepare and drink ginger root tea then you are able to get relief easily. The following are the steps that you need to follow in order to prepare ginger root tea.
First of all, you have to take the ginger root and along with that you should take 1 cup of hot water. Then you should place the ginger pieces in a cup and you should add the hot water into it. You should steep it upto 5 minutes and then you can have the drink.

Garlic:

Garlic is an excellent home remedy for treating chest pain therefore individuals can prefer this whenever they feel chest pain. Actually ginger is included with vitamins as well as minerals such as iron, thiamine, phosphorus, calcium, riboflavin, vitamin c and niacin. Garlic can easily fight health diseases, asthma, cough and many other health problems therefore it will definitely be very effective as people expect. Garlic can be used in different ways and the following are some of them.


People can swallow a clove of garlic with water every morning and on the empty stomach. Otherwise they can take around 10 drops of garlic juice along with 2 teaspoons of honey in one glass of water. If you want to use it in a simple manner then you can take few drops of garlic juice and mix with a glass of hot water. Drinking this mixture will definitely give better relief from chest pain. 


cd10-tipsheet-cardiology

1 401.9 Unspecified essential hypertension I10 Essential (primary) hypertension
2 401.1 Benign essential hypertension I10 Essential (primary) hypertension
3 786.50 Chest pain, unspecified R07.9 Chest pain, unspecified
4 272.4 Other and unspecified hyperlipidemia E78.4 Other hyperlipidemia

E78.5 Hyperlipidemia, unspecified

5 414.01 Coronary atherosclerosis of native coronary artery I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris

I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris

I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm

I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris

I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris


6 427.31 Atrial fibrillation I48.0 Paroxysmal atrial fibrillation

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