Rib Pain ICD 10 - Etiologies and Common Codes

Rib pain is the discomfort, aching, stabbing, or pressure sensation arising from the ribs, costochondral junctions, intercostal muscles, or chest wall. Depending upon the type, a specific rib pain ICD-10 code is used. Use of R07.89 should only be in cases where no more specific cause is confirmed.

It’s important to note that rib pain may worsen with breathing, movement, coughing, or palpation. Let’s take a deep dive into etiologies and their relevant codes.

• Rib pain has many etiologies
• Trauma / rib fracture or contusion
• Intercostal muscle strain or nerve irritation
• Costochondritis / Tietze syndrome (inflammation of costochondral junction)
• Pleural irritation (pleurisy)
• Idiopathic / non-specific musculoskeletal chest wall pain

Pleurisy (also called pleuritic pain) is the inflammation of the pleura (the membrane lining the lungs and inner chest wall). This often causes sharp pain on breathing (pleuritic chest pain).

Common Rib or Chest Pain Codes (ICD-10 R07 series) and Definitions

Here are the relevant ICD 10 R07 (Pain in throat and chest) codes often used in rib or chest wall pain cases. From a coding perspective, the challenge is choosing the most specific ICD-10 code supported by documentation and distinguishing rib pain from generic chest pain.

Key points:

• R07.89 is now being promoted as the preferred code for generic rib pain ICD-10 cases where no fracture, pleurisy, or intercostal cause is documented.
• R07.81 should not be overused just because pain is on the ribs; it requires evidence of pleural / pleuritic etiology (e.g. sharp pain with respiration, pleural inflammation).
• R07.82 is more specific (intercostal), so use it if documentation states “intercostal pain,” “pain between ribs,” etc. Symptoms may include sharp pain that worsens upon movement, tenderness between ribs (according to MedicalNewsToday), and more.

Avoid defaulting to R07.9 unless absolutely no detail is available.

Is the administrative burden too high?

Outsource coding/billing to a HIPAA-compliant medical billing firm like Hello MDs. Get a no-obligation quote today.

Rib Pain ICD Code for Trauma Fracture and Others

When rib pain arises due to trauma, fracture, or other structural / inflammatory causes, use more specific ICD-10 codes beyond the R07 family:

• S22.3x – Fracture of ribs (various laterality, number of ribs, initial/subsequent encounters)
  e.g. S22.31XA = Fracture of one right rib, initial encounter for closed fracture (used when imaging confirms)
  e.g. S22.32XA = Fracture one left rib, initial encounter
• S23.4x – Rib sprain/strain / dislocation codes (if documented).

Check this guide for detailed info on S22 codes.

• M94.0 – Tietze syndrome (costochondritis) — use when there is inflammation of costochondral junctions, with documented swelling or tenderness (distinct from generic rib pain).

Thus, rib pain left ICD-10 code or rib pain right ICD-10 code in a traumatic context becomes a side-specific fracture or injury code, not R07.89. (In the non-traumatic context, laterality is usually not coded in R07.89.)

Left vs. Right Rib Pain — ICD-10 Nuance

• Codes in the R07 symptom category (R07.89, R07.81, R07.82) are not laterality-specific. Whether a patient has left rib pain ICD-10 or right rib pain ICD-10, you still use the same R07 code (e.g., R07.89) when no structural diagnosis is confirmed.
• Documentation should mention laterality (“left side rib pain,” “right rib pain”) to support coder clarity — but the ICD-10 code remains R07.89 for nonspecific cases.
• If fracture / injury, codes S22.x (and others) have distinct left/right versions (e.g. S22.31XA right; S22.32XA left) so laterality is crucial there.

Recent Updates/Coding Trends for Rib Pain ICD-10

• According to Yes HIM Consulting, a recent update (as of late 2024) recommends that rib pain diagnoses (without a specific etiology) be coded under R07.89 (Other chest pain) rather than under R07.81 (pleurodynia). That is a key shift in practice.
• In other sources, many coder guides and ICD documentation sites already treat R07.89 as the default for generic rib pain.
• There is no new, entirely separate “rib pain ICD-10 code” created — rib pain remains nested under chest pain/symptom codes unless a structural diagnosis is confirmed.
• Always check the latest ICD-10-CM annual updates and Coding Clinic guidance for 2025/2026 to see if further changes occur.

Suggested Workflow/Tips for Coders and Physicians

• Document Precisely: side (left/right), location (rib, intercostal, costochondral), character (sharp, aching), aggravating factors (breathing, movement), history of trauma, imaging, and exam findings.
• Start with a specific diagnosis if confirmed (fracture, Tietze, costochondritis).
• If no definitive structural cause, choose the most specific symptom code (R07.82 if intercostal, R07.81 if pleuritic, else R07.89).
• Avoid overuse of R07.9 (unspecified chest pain) when details exist.
• For injury codes (S22 series), use proper laterality and seventh-character (initial, subsequent, sequela).
• Be consistent in linking medical necessity (why imaging, lab, or treatment was needed) to the rib pain diagnosis.
• Query the provider if documentation is vague (e.g. “rib pain” without further detail).

Similar to rib pain, skin-related conditions also require precise coding. Learn more in our Onychomycosis ICD-10 coding guide.

How Medical Billing Company Helps with Rib Pain ICD Code

1. Accurate ICD-10 Code Assignment – Ensures correct rib pain coding (e.g., R07.81 – Pleurodynia, R07.82 – Intercostal pain, R07.89 – Other chest pain) to avoid claim denials.
2. HIPAA Compliance – Protects patient health information while processing rib pain-related medical claims securely.
3. Claim Submission & Reimbursement – Files rib pain ICD-coded claims promptly to insurance providers for faster reimbursements.
4. Denial Management – Reviews and corrects coding or documentation errors if rib pain claims are denied, improving approval rates.
5. Medical Documentation Review – Matches rib pain symptoms with proper ICD-10 codes based on clinical notes.
6. Provider Support – Guides healthcare providers in coding rib pain accurately for clean claim submission.
7. Revenue Cycle Optimization – Prevents revenue loss by reducing coding errors and ensuring timely payments.

Conclusion

Partnering with a HIPAA-compliant medical billing company, Hello MDs ensures that the correct rib pain ICD-10 code is applied, patient health information remains protected, and insurance claims are submitted seamlessly. With professional medical billing services, providers can minimize claim denials, improve reimbursements, and maintain accurate coding for conditions like rib pain and chest pain.

By focusing on HIPAA compliance and revenue cycle management, a trusted billing partner helps healthcare practices streamline operations, maximise revenue, and dedicate more time to quality patient care.

Disclaimer: This blog is for informational purposes only and does not constitute medical, legal, or professional advice. While we strive for accuracy, errors or omissions may occur. Some images in this blog may be AI-generated or for illustrative purposes only.