Chest Pain ICD-10 Coding a Complete Guide for 2025

Use R07.9 when the provider documents chest pain without specifying the cause (e.g., non-cardiac, non-traumatic) or when further testing is pending. It’s a temporary code until a definitive diagnosis is confirmed.

• 1: Sharp, pleurisy pain (e.g., worsened by breathing).
• 89: Atypical chest pain (e.g., linked to anxiety or GERD).
• 9: A “catch-all” for unspecified cases. Always default to more specific codes if details are available.

Providers must:

• State that the cause is “unspecified” or “unknown.”
• Rule out urgent conditions (e.g., myocardial infarction) in notes.
• Avoid terms like “cardiac chest pain” unless confirmed.

Modifiers like 25 (separate E/M service) may apply if chest pain is addressed during a visit with other procedures. Avoid 59 unless distinct services are performed.

Common reasons:

• Overuse without clinical justification.
• Missing documentation linking pain to a symptom (e.g., “chest pain due to cough” should use R07.89).
• Incorrectly coding chronic pain as acute (or vice versa).

Yes, but payers may audit claims if used excessively. Pair with a detailed clinical note to show medical necessity.

For pregnancy, code O99.89 (other maternal conditions) alongside R07.9 if the cause isn’t specified (e.g., “chest pain in third trimester”).