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ED Coding and Reimbursement Alert

Reader Questions:

Don’t Combine Chest Pain, SOB Symptoms

Published on Tue Jun 11, 2024

Question: A patient reports to the ED with chest pain and shortness of breath (SOB). I was going to report R07.1 (Chest pain on breathing) as a diagnosis. Is this correct, as it indicates both the chest pain and breathing issues?

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Answer: Though it does address the chest pain and breathing issues, it isn’t the diagnosis code you’ll want for this patient. In fact, you’ll need a pair of diagnosis codes for this patient’s symptoms.

On the claim, report:

  • R07.9 (Chest pain, unspecified) for the chest pain
  • R06.02 (Shortness of breath) for the SOB

Why not R07.1? This ICD-10 code might have all the right words in the descriptor, but it doesn’t describe the separate symptoms of chest pain and SOB. Use R07.1 as a diagnosis when a patient is suffering from painful respiration.

In your scenario, it is more accurate to describe the chest pain and SOB with separate ICD-10 codes.

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