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v1.0.0
ICD-10 Guide
DiagnosesSternum Pain

Sternum Pain

ICD-10 Coding for Sternum Pain(M94.0, R07.89, S22.20XA)

PRIMARY SPECIALTYPrimary Care
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Sternum Pain?
Essential facts and insights about Sternum Pain

Key Clinical Considerations:

  • Localized pain in the sternum area, often described as sharp or aching
  • Pain may worsen with movement, deep breathing, or palpation
  • Key diagnostic tests include chest X-ray, ECG, and possibly echocardiogram to rule out cardiac causes
  • Physical exam may reveal tenderness over the sternum, normal heart sounds, and no respiratory distress

Clinical Information

Clinical Criteria & Documentation Requirements

  • Document patient's history of present illness, including onset, duration, and character of pain
  • Use specific terminology such as 'costochondritis' or 'sternoclavicular joint pain' when applicable
  • Examples include noting any associated symptoms like shortness of breath or radiation of pain

Coding Guidelines

Usage Guidelines & Examples

  • Follow usage guidelines for each ICD code to ensure appropriate billing and reimbursement.
  • Common errors include misclassifying the type of pain or failing to document associated symptoms.

Code Exclusions

Important Exclusions

  • Excludes conditions such as myocardial infarction, pulmonary embolism, or rib fractures
  • Alternative codes may include those for gastrointestinal causes of chest pain

Related ICD-10 Codes

Primary Codes
R07.1
Chest pain on breathing
M54.6
Pain in thoracic spine
R07.9
Chest pain, unspecified
Ancillary Codes
G89.11
Differential Codes
R07.89
M94.0
M94.0
if costochondritis is confirmed.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Primary Care

Specialty Applications

  • Adult and pediatric populations experiencing sternum pain
  • Primary care settings, urgent care, and emergency departments

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

Documentation requirements?

Include detailed history, physical exam findings, and any diagnostic tests performed.

Billing considerations?

Ensure accurate coding to reflect the specific diagnosis and any associated conditions.