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ICD-10 Guide
ICD-10 CodesM25.571

M25.571

Billable

Pain in right ankle and joints of right foot

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M25.571 is a billable code used to indicate a diagnosis of pain in right ankle and joints of right foot.

Key Diagnostic Point:

M25.571 refers to pain localized in the right ankle and joints of the right foot, which can arise from various underlying conditions. This pain may be due to internal derangements such as meniscal tears, ligament injuries, or degenerative joint diseases. Meniscal tears, although more commonly associated with the knee, can lead to referred pain in the ankle and foot due to altered biomechanics. Ligament injuries, particularly in the ankle, can result from acute trauma or repetitive stress, leading to instability and pain. Additionally, arthritic conditions, including osteoarthritis or rheumatoid arthritis, can cause joint pain and inflammation in these areas. Accurate diagnosis often requires imaging studies, such as X-rays or MRIs, to assess for structural abnormalities. Treatment may involve conservative management, including physical therapy and pain relief medications, or surgical interventions like arthroscopy to repair damaged ligaments or remove loose bodies. Understanding the specific etiology of the pain is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various causes of joint pain (e.g., arthritis vs. ligament injury)
  • Need for precise documentation of the location and nature of pain
  • Potential for multiple underlying conditions contributing to symptoms
  • Variability in treatment approaches based on the underlying cause

Audit Risk Factors

  • Inadequate documentation of the specific joint affected
  • Failure to specify the underlying cause of pain
  • Lack of imaging results to support the diagnosis
  • Inconsistent coding of related conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and imaging results.

Common Clinical Scenarios

Patients presenting with acute ankle sprains, chronic ankle instability, or post-surgical pain.

Billing Considerations

Ensure that all relevant findings are documented to support the diagnosis and any surgical interventions.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive assessment of functional limitations and pain levels, along with treatment plans.

Common Clinical Scenarios

Patients undergoing rehabilitation post-injury or surgery, or those with chronic pain syndromes.

Billing Considerations

Focus on functional outcomes and the impact of pain on daily activities.

Coding Guidelines

Inclusion Criteria

Use M25.571 When
  • According to ICD
  • 10 coding guidelines, M25
  • 571 should be used when the primary complaint is pain in the specified areas without a more specific diagnosis
  • It is essential to document the duration, intensity, and nature of the pain, as well as any associated symptoms

Exclusion Criteria

Do NOT use M25.571 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

29891CPT Code

Arthroscopy, ankle, surgical

Clinical Scenario

Used for patients undergoing surgical intervention for ligament repair or removal of loose bodies.

Documentation Requirements

Operative reports detailing the procedure performed and findings.

Specialty Considerations

Orthopedic surgeons must ensure that the diagnosis aligns with the surgical procedure.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like M25.571, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and treatment efficacy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like M25.571, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and treatment efficacy.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of patient outcomes and treatment efficacy.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What documentation is needed to support the use of M25.571?

Documentation should include a detailed history of the patient's symptoms, physical examination findings, imaging results, and any treatments provided. It is important to specify the nature and duration of the pain.