ICD Code M79.604

ICD code M79.604 is used to identify and classify the medical condition of pain located specifically in the right leg. This code is part of the International Classification of Diseases, 10th Revision (ICD-10), which is utilized by healthcare providers to document diagnoses and conditions for billing and statistical purposes. The code helps ensure accurate communication and processing within the healthcare revenue cycle, facilitating appropriate treatment and reimbursement.

1. Localized Pain: The patient reports experiencing pain specifically in the right leg, without any accompanying pain in other areas of the body.

2. Duration of Pain: The pain has persisted for a significant period, typically beyond the expected time frame for acute pain, indicating a chronic condition.

3. Impact on Mobility: The pain in the right leg affects the patient's ability to walk, stand, or perform daily activities, suggesting a need for medical evaluation and intervention.

4. Absence of Trauma: There is no recent history of trauma or injury to the right leg that could explain the pain, necessitating further investigation into underlying causes.

5. Exclusion of Systemic Conditions: The pain is not associated with systemic conditions such as arthritis, vascular disorders, or neurological diseases, which would require different diagnostic codes.

6. Physical Examination Findings: Upon examination, there may be tenderness, swelling, or other physical signs localized to the right leg that correlate with the patient's reported pain.

7. Patient History: The patient's medical history does not indicate previous conditions or surgeries that could account for the current pain, prompting the use of this specific diagnostic code.

8. Diagnostic Tests: Imaging or other diagnostic tests do not reveal specific pathologies such as fractures, tumors, or infections, supporting the use of a general pain code.

9. Symptom Consistency: The pain is consistent in nature and intensity, without significant fluctuations or changes over time, aligning with the criteria for this code.

10. Exclusion of Referred Pain: The pain is not referred from another part of the body, such as the lower back or hip, confirming its origin in the right leg.

For the ICD code M79.604, which pertains to pain in the right leg, the relevant CPT codes that may be applicable for treatment and management include:

1. 99201-99205 - New patient office or other outpatient visit codes, depending on the complexity of the evaluation and management.

2. 99211-99215 - Established patient office or other outpatient visit codes, depending on the complexity of the evaluation and management.

3. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., knee, hip, shoulder joint).

4. 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia").

5. 20551 - Injection(s); single tendon origin/insertion.

6. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility.

7. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

8. 97032 - Application of a modality to one or more areas; electrical stimulation (manual), each 15 minutes.

9. 97035 - Application of a modality to one or more areas; ultrasound, each 15 minutes.

These CPT codes are examples of procedures and services that may be utilized in the treatment and management of pain in the right leg, as indicated by ICD code M79.604. The selection of specific CPT codes should be based on the individual patient's clinical needs and the healthcare provider's professional judgment.

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