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v1.0.0
ICD-10 Guide
ICD-10 CodesR07.1

R07.1

Chest pain on breathing

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R07.1 is a billable code used to indicate a diagnosis of chest pain on breathing.

Key Diagnostic Point:

Chest pain on breathing, classified under ICD-10 code R07.1, refers to discomfort or pain experienced in the chest that is exacerbated by breathing movements. This symptom can arise from various underlying conditions, including respiratory, cardiovascular, and musculoskeletal issues. Patients may describe the pain as sharp, stabbing, or aching, and it may be localized or diffuse. Common causes include pleuritis, pneumonia, pulmonary embolism, rib fractures, or costochondritis. The pain may be accompanied by other symptoms such as shortness of breath, cough, or fever, which can aid in determining the underlying cause. A thorough clinical evaluation, including a detailed history and physical examination, is essential to identify the etiology of the chest pain. Diagnostic imaging, such as chest X-rays or CT scans, and laboratory tests may be warranted to rule out serious conditions. Accurate documentation of the patient's symptoms, duration, and associated factors is crucial for appropriate coding and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for thorough clinical evaluation
  • Differentiation from other types of chest pain
  • Documentation of associated symptoms

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify the underlying cause
  • Misuse of related codes
  • Lack of clinical correlation in documentation

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of present illness, including onset, duration, and characteristics of pain, as well as associated symptoms.

Common Clinical Scenarios

Patients presenting with chest pain due to pneumonia or pleuritis.

Billing Considerations

Ensure that all relevant clinical findings are documented to support the diagnosis and coding.

Emergency Medicine

Documentation Requirements

Acute care documentation must include vital signs, initial assessment findings, and any immediate interventions performed.

Common Clinical Scenarios

Patients presenting with acute chest pain due to pulmonary embolism or pneumothorax.

Billing Considerations

Rapid assessment and documentation are critical; ensure that all differential diagnoses are considered.

Coding Guidelines

Inclusion Criteria

Use R07.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the code is used only when chest pain is specifically related to breathing and not due to other causes
  • Document the clinical rationale for the diagnosis

Exclusion Criteria

Do NOT use R07.1 When
No specific exclusions found.

Related CPT Codes

99283CPT Code

Emergency department visit, moderate severity

Clinical Scenario

Used when a patient presents with chest pain on breathing requiring moderate complexity evaluation.

Documentation Requirements

Document the history, examination findings, and medical decision-making.

Specialty Considerations

Emergency medicine providers should ensure all relevant findings are documented to support the visit level.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of symptoms like chest pain on breathing, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of symptoms like chest pain on breathing, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 should be documented to support the use of R07.1?

Document the characteristics of the chest pain, associated symptoms, and any relevant clinical findings or diagnostic tests that support the diagnosis.