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v1.0.0
ICD-10 Guide
DiagnosesAxillary Pain

Axillary Pain

ICD-10 Coding for Axillary Pain(M25.512, G54.0)

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

Diagnosis Overview

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

Key Clinical Considerations:

  • Localized pain in the axillary region
  • Radiating pain to the shoulder or upper arm
  • Possible swelling or tenderness in the axilla

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including onset, duration, and nature of pain
  • Physical examination findings including range of motion and tenderness
  • Imaging results if applicable (e.g., X-rays, MRI)

Coding Guidelines

Usage Guidelines & Examples

  • Usage guidelines: Use specific codes for underlying conditions if known.
  • Common errors: Misclassifying axillary pain as shoulder pain.

Code Exclusions

Important Exclusions

  • Fractures or dislocations of the shoulder
  • Cervical radiculopathy

Related ICD-10 Codes

Primary Codes
M79.1
Myalgia
M25.51
Pain in shoulder
Differential Codes
G54.0
M25.512

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Orthopedics

Specialty Applications

  • Adult and pediatric populations
  • Orthopedic clinics, urgent care, and primary care settings

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 patient history and physical exam findings.

Billing considerations?

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