Hip pain is classified under ICD-10-CM code M25.55, which requires specifying the affected side. Common billable codes include M25.551 (right hip), M25.552 (left hip), and M25.559 (unspecified hip).
Primary codes
Billable
Billable
Extension
—
7th character
—
POA exempt
No
Coding risks
- Coding based on lab values alone without provider interpretation
Hierarchy
Code comparison
Compare key differences between related codes to select the most specific option.
| Code | Description | Scenario |
|---|---|---|
| M25.551 | Pain in right hip | Patient with hip pain clearly documented on the right side, laterality specified in the record. |
| M25.552 | Pain in left hip | Left hip pain documented with laterality clearly specified in the clinical note. |
| M25.559 | Pain in unspecified hip | Hip pain documented without laterality specified in the chart. |
Select the most specific code supported by the encounter documentation. More specific codes improve reimbursement accuracy and reduce audit risk.
Code ranges
Pain in joint
Category for unspecified joint pain by anatomic site when no underlying disorder or mechanism is documented.
Other joint disorders
Sub-chapter covering acquired deformities, joint derangements, and other specified joint conditions not classified elsewhere.
Osteoarthritis of hip
Category for primary, secondary, and post-traumatic osteoarthritis affecting one or both hip joints.
Injuries to the hip and thigh
Chapter 19 range covering traumatic injuries including contusions, sprains, and fractures of the hip and thigh region.
Pain, not elsewhere classified
Category for generalized, chronic, or acute pain not attributable to a specific anatomic site or condition.
Coding risks
Avoid these common coding issues when reporting Hip Pain.
Impact
Assigning M25.55 without explicit laterality may default to M25.559 and reduce claim specificity.
Mitigation
Consider querying the provider when laterality is absent rather than inferring from imaging side or exam findings.
Related codes
Ancillary and co-coding
Codes commonly reported with the primary diagnosis on the same claim.
Z-code variants
Family history, personal history, or screening encounter codes related to this condition.
Differential codes
Alternative or commonly confused codes to consider when documentation suggests a different condition than the primary diagnosis.
Frequently asked questions
Use M25.559 only when laterality is truly undocumented. Per guidelines, query the provider whenever the affected side could reasonably be clarified.
References
Compiled from the following authoritative coding references. Last updated 2026-08-04.