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.