Internal Medicine Coding Alert

Question: A new patient reports to the internist complaining of chest pain. The internist rules out a heart condition; we are debating whether or not to use the costochondritis diagnosis code for this condition. What ICD-9 code should I use?

Oklahoma Subscriber

Answer: For costochondritis, the ICD-9 index will point you to 733.6 (Tietze's disease). Both costochondritis and costochondral junction syndrome are bundled into this code.

Be careful: Do not consider costochondritis, costochondral junction syndrome, and chest pain as similar diseases. They were bundled into this code because they have similar presenting problems to chest pain. If a more definitive diagnosis, such as myocardial infarction or costochondritis, cannot be established, use a primary diagnosis of chest pain (786.5x).

According to the Mayo Clinic: "Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain in the costosternal joint -- where your ribs and breastbone are joined by rubbery cartilage. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions."

(http://www.mayoclinic.com/health/costochondritis/DS00626).

-- Answers to You Be the Coder and Reader Questions were reviewed by Bruce Rappoport, MD, CPC, CHCC, a board-certified internist and medical director of Broward Health's Best Choice Plus and Total Claims Administration in Fort Lauderdale, Fla.