A patient limps in with a sore right hip, the provider writes “hip pain,” and the coder picks the first hip code that looks close. Weeks later, the payer denies the injection for a laterality mismatch. That small mistake costs practices real money every day. This guide gives you the correct right hip pain ICD 10 code, the left, bilateral, and unspecified variants, and the documentation that keeps hip claims paid the first time.

TL;DR

• The right hip pain ICD 10 code is M25.551 (Pain in right hip). Left hip pain is M25.552, and unspecified hip pain is M25.559.
• M25.55, the parent code, is not billable. Always report one of the three six-character codes.
• No bilateral hip pain code exists. Report M25.551 and M25.552 together.
• M25.551 is a symptom code. Once the provider confirms osteoarthritis, bursitis, or a tear, code the diagnosis instead.
• For chronic right hip pain, add G89.29 when the provider documents chronic pain.
• Pain from a hip replacement codes to T84.84XA with Z96.641, not M25.551.
• Thigh pain codes to M79.651, not M25.551.
• The M25.55 codes carry no changes for FY2027.

What Is the ICD-10 Code for Right Hip Pain?

The ICD-10-CM code for right hip pain is M25.551, Pain in right hip. It is a billable symptom code in subcategory M25.55 (Pain in joint, hip), which sits in Chapter 13, Diseases of the musculoskeletal system and connective tissue (M00-M99). The parent code M25.55 is not billable on its own.

Here are the key facts in one place:

• Code: M25.551
• Billable: Yes
• Parent: M25.55 (not billable)
• Laterality: Right
• Excludes2 on M25.5: Pain in limb (M79.6-), pain in hand and fingers (M79.64-), pain in foot and toes (M79.67-)
• ICD-9 crosswalk: 719.45 (Pain in hip joint), which maps to all three M25.55 codes

An Excludes2 note means the two conditions can occur together. So when the provider documents hip joint pain and separate thigh pain, you may report both M25.551 and M79.651. You can confirm the note in the official CDC ICD-10-CM code files.

Hip Pain ICD-10 Codes: Right, Left, and Unspecified (M25.55 List)

Subcategory M25.55 holds three billable codes. Each one depends on laterality.

Laterality matters here. The ICD-10-CM Official Guidelines, Section I.B.13, tell coders to use the unspecified side only when the record truly does not state it. Therefore, when the physician notes “right hip pain” anywhere in the encounter, M25.559 is the wrong choice and a frequent audit finding.

Transposition errors cause problems too. The right and left codes differ by a single digit, so a left hip code on a right hip injection claim produces an easy denial.

What Is the ICD-10 Code for Left Hip Pain?

The ICD-10 code for left hip pain is M25.552, Pain in left hip. It follows the same rules as M25.551: a billable symptom code for pain in the left hip joint when the provider has not confirmed a cause.

Coders sometimes search for a “left hip pain unspecified” code. No such code exists. “Unspecified” in this subcategory refers only to laterality, so a documented left side always codes to M25.552.

Finally, match the code to the side on the procedure line. When you bill an injection with an RT or LT modifier, the diagnosis must point to the same hip.

How Do You Code Bilateral Hip Pain?

ICD-10-CM has no bilateral hip pain code. When the provider documents pain in both hips, report both M25.551 and M25.552.

Do not use M25.559 as a shortcut for bilateral pain. That code means the side was not recorded, not that both sides hurt. Likewise, no modifier turns M25.559 into a bilateral code, and M25.851 and M25.852 describe other joint disorders, not pain.

Hip osteoarthritis works differently. It does have a bilateral code, M16.0, so once the provider confirms OA in both hips, that single diagnosis code replaces both pain codes.

When Should You Use M25.559 (Hip Pain Unspecified)?

Use M25.559, Pain in unspecified hip, only when no part of the record names the side. It is billable, but payers flag it as a specificity problem, and it should be rare.

Before you submit M25.559, check the full encounter. The chief complaint, exam, imaging order, or procedure note usually states the side. If none of them does, send a query to the provider rather than defaulting to the unspecified code on a recurring basis.

One more caution: M79.3 is not a hip pain code. It describes panniculitis, even though some online guides list it as an alternate hip pain option.

Is M25.551 a Symptom Code or a Diagnosis Code?

M25.551 is a symptom code. Section I.B.4 of the FY2027 ICD-10-CM Official Guidelines directs coders not to report a sign or symptom when the provider has established a related definitive diagnosis.

In practice, that rule plays out across the course of care:

• First visit, cause unknown: The provider documents “right hip pain, will order X-ray.” Code M25.551.
• Follow-up, cause confirmed: The X-ray shows osteoarthritis, and the provider documents “right hip OA.” Code M16.11 and drop M25.551.
• Pain unrelated to the diagnosis: The provider documents OA in the left hip and separate, unexplained pain in the right hip. Code both M16.12 and M25.551.

When Should You Use M25.551?

Use M25.551 when the provider documents pain in the right hip joint, has not confirmed a cause, and the pain does not stem from trauma, a prosthesis, or a surgical complication.

Watch for these red flags before you submit it:

• The assessment names bursitis, tendinitis, osteoarthritis, or a labral tear. A specific diagnosis code applies.
• The patient has a right hip replacement, and the pain relates to the implant. Use T84.84XA.
• The provider describes pain in the thigh rather than the joint. Use M79.651.
• The chart says “chronic,” and the provider treats the pain itself. Add G89.29.

In short, the right hip pain ICD 10 code belongs on an early or undiagnosed encounter, not on every hip visit.

How Do You Code Chronic Right Hip Pain?

When the provider documents chronic right hip pain, report G89.29, Other chronic pain, together with M25.551. Section I.C.6.b of the Official Guidelines allows a category G89 code with a site-specific pain code when it adds information about whether the pain is acute or chronic.

Sequencing depends on the reason for the visit. For a pain management encounter that focuses on treating the pain, sequence G89.29 first. For a workup visit that focuses on finding the cause, sequence M25.551 first.

ICD-10-CM sets no duration threshold. “Chronic” is a provider documentation decision, not a three-month rule. Coders cannot assign G89.29 based on how long the pain has lasted.

ICD-10 Codes Often Confused With Right Hip Pain

Several nearby codes look like a fit for hip pain but describe a different condition or site. Use this table to pick the correct one.

Acute Hip Pain After a Fall or Injury

Traumatic hip pain never codes to M25.551. Instead, report the injury from Chapter 19 with the correct seventh character: A for the initial encounter, D for subsequent care, and S for sequela. Non-traumatic acute pain stays in the M25.55 subcategory.

What Is the ICD-10 Code for Right Hip Pain After a Hip Replacement?

Pain caused by a right hip prosthesis codes to T84.84XA (initial encounter), T84.84XD (subsequent encounter), or T84.84XS (sequela). Also report Z96.641, Presence of right artificial hip joint.

Two scenarios look alike but code differently:

• Pain attributed to the implant: Code T84.84XA with Z96.641.
• Pain not attributed to the implant: The provider documents right hip pain in a patient with a prior replacement but does not link it to the device. Code M25.551 and Z96.641.

The provider must document the link. Coders cannot assume that pain in a replaced hip comes from the prosthesis. Also note that G89.18 covers acute pain after a procedure, not pain caused by a device.

What Documentation and CPT Pairings Support a Hip Pain Claim?

Payers rarely deny the right hip pain ICD 10 code by itself. However, they do deny the services billed with it when the note is thin. A strong hip pain note includes:

• Laterality, stated clearly as “right hip”
• Location: groin, lateral hip, or buttock
• Onset and duration, with “acute” or “chronic” when the provider decides it applies
• Severity and functional impact, such as limited walking or stairs
• Exam findings: range of motion, tenderness, gait, and provocative tests
• Imaging ordered and the result
• The plan, plus a working differential or a confirmed diagnosis at follow-up

Common CPT pairings include 20610 (major joint injection), 73502 and 73522 (hip X-ray), 73721 (MRI of the hip without contrast), 97110 and 97140 (physical therapy), and 98940 through 98942 (chiropractic manipulation). Check your Medicare Administrative Contractor’s Local Coverage Determination for injections and advanced imaging, because a symptom code alone rarely supports an MRI. CMS publishes the current code files on its ICD-10 codes page.

Common Hip Pain Denials and How to Fix Them

Most hip pain denials follow a predictable pattern, and each one has a clear fix.

For a step-by-step appeal process, see our Medical Denial Management Playbook and the CARC and RARC reference guide.

Coding Hip Pain by Care Setting

Orthopedics and Pain Management

These practices see the most hip pain visits, so symptom-to-diagnosis transitions happen often. Build a habit of updating the code once imaging returns. Then pair G89.29 with M25.551 on chronic pain visits that center on treatment.

Home Health (PDGM)

M25.551 is a symptom code, and symptom codes generally do not qualify as an acceptable primary diagnosis under PDGM. Agencies should look for the underlying condition, such as osteoarthritis or hip fracture aftercare, as the primary diagnosis. Our Home Health Billing Guide covers primary diagnosis rules in detail.

Hospice

Hip pain usually appears as a related symptom rather than the terminal diagnosis. Document the comfort care plan, including pain management, and keep the principal diagnosis aligned with the list of unacceptable hospice principal diagnosis codes.

Chiropractic

Chiropractic claims often pair M25.551 with M99.0- segmental dysfunction codes. Each diagnosis must support the regions adjusted, because payers compare the diagnosis list to the CPT code billed (98940 through 98942). Extraspinal manipulation of the hip bills as 98943, which Medicare does not cover.

Physical Therapy

Therapists can bill M25.551 when it matches the referral. Once the physician confirms a diagnosis, carry that code on the plan of care. A specific diagnosis also makes visit limits and prior authorizations easier to defend.

Conclusion

The right hip pain ICD 10 code is M25.551, and the rules around it are simple once you see the pattern. Match the code to the documented side, report both laterality codes for bilateral pain, and leave M25.559 for the rare record that never names a hip. Then retire the symptom code the moment the provider confirms a diagnosis.

Three details separate clean claims from denied ones. Add G89.29 only when the provider documents chronic pain, send prosthesis pain to T84.84XA, and keep trauma in Chapter 19. Follow those rules, and your hip pain claims will pass the first review.

Get Your Orthopedic Claims Paid the First Time

Right On Time Billing’s certified coders review hip, spine, and joint claims before they reach the payer. As a result, you catch the wrong right hip pain ICD 10 code, outdated symptom codes, and missing chronic pain codes early. Book a free coding audit and protect the revenue your team already earned.

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• Medical Coding Audits 2026
• Home Health Denial Codes and RTP Guide
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• Medical Coding Services
• Denial Management Services
• CMS: FY2027 ICD-10-CM Official Guidelines (PDF)
• CDC NCHS: ICD-10-CM files