ICD-10-CM · Other

M94.0

M94.0 identifies chondrocostal junction syndrome (Tietze syndrome), a benign inflammatory condition of one or more costal cartilages — most commonly at the second rib — presenting with anterior chest pain and localized swelling at the costochondral junction. Costochondritis is classified here under the Applicable To annotation.

Verified May 8, 2026 · 7 sources ↓

Status: Billable
Chapter: 13
Related CPT: 8
Region: Other

Drawn from CDCICD10DataAAPCIcdcodesCdek

Documentation tips

What should appear in the chart to support M94.0.

Source · Editorial brief grounded in 7 cited references ↓

Specify the affected rib level(s) and side (e.g., 'right second costochondral junction') even though M94.0 does not capture laterality — this detail supports medical necessity and audit defense.
Document reproducible tenderness on palpation at the costochondral or costosternal junction; this clinical finding distinguishes M94.0 from non-specific chest pain codes (R07.-).
Record whether swelling is present — visible or palpable swelling is a hallmark of Tietze syndrome specifically and strengthens the diagnosis over simple costochondritis.
If imaging (ultrasound, CT, or MRI) was obtained to rule out other etiologies, note the findings that support cartilage inflammation and exclude cardiac or pulmonary sources.
When a secondary etiology (e.g., rheumatoid arthritis, ankylosing spondylitis) contributes to the inflammation, document that relationship explicitly so coders can sequence codes correctly.

Related CPT procedures

Procedure codes commonly billed with M94.0. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

20550 $60.46

Injection into a single tendon sheath, ligament, or aponeurosis (such as the plantar fascia) — one anatomical site per unit.

20605 $57.12

Aspiration and/or injection of an intermediate joint or bursa — such as the wrist, elbow, ankle, acromioclavicular joint, or olecranon bursa — performed without ultrasound guidance.

20610 $68.81

Aspiration and/or injection of a major joint or bursa (shoulder, hip, knee, or subacromial bursa) performed without ultrasound guidance.

97110 $29.06

Therapeutic exercise billed per 15-minute unit, targeting strength, endurance, range of motion, or flexibility with direct one-on-one patient contact.

97140 $27.72

Skilled, hands-on manual therapy techniques — including joint mobilization/manipulation, manual lymphatic drainage, and manual traction — applied to one or more body regions, billed per 15-minute unit.

99213 $95.19

Established patient office or outpatient visit requiring 20–29 minutes of total time or low-complexity medical decision-making.

99214 $135.61

Office visit for an established patient requiring moderate-complexity medical decision making (MDM), or 30–39 minutes of total provider time on the date of service.

99215 $192.39

Highest-level office or outpatient E/M visit for an established patient, qualifying via high-complexity medical decision making or 40–54 minutes of total provider time on the date of service.

Common coding pitfalls

The recurring mistakes coders make with M94.0 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Using R07.1 (chest pain on breathing) or R07.9 (chest pain, unspecified) when the provider has documented costochondritis — M94.0 is the correct specific code and should be used instead.
Failing to sequence M94.0 as a secondary code when an underlying rheumatologic condition is the primary driver of cartilage inflammation, reversing the correct code order.
Conflating M94.0 with M94.8X- (other specified disorders of cartilage) — the index maps 'costal chondritis' and 'costochondritis' directly to M94.0, not to M94.8.
Assigning M94.0 for chest pain that lacks documented palpatory tenderness at the costochondral junction — unsupported specificity invites payer downcoding to an R07.- code.
Overlooking the MS-DRG grouping: M94.0 falls under DRG 205/206 (Other respiratory system diagnoses), not a musculoskeletal DRG — this affects facility reimbursement calculations.

Clinical context

Source · Editorial summary grounded in 7 cited references ↓

Use M94.0 when the provider documents costochondritis, Tietze syndrome, Tietze's disease, or chondrocostal junction syndrome with reproducible anterior chest wall tenderness and/or swelling. The condition is idiopathic, nonsuppurative, and benign, but its anterior chest pain pattern can clinically mimic cardiac or pulmonary pathology — making precise documentation and code assignment critical for accurate DRG grouping and payer adjudication.

M94.0 carries no laterality or rib-level specificity in ICD-10-CM; the code is the same regardless of whether the second, third, or another rib is involved, or whether the presentation is unilateral or bilateral. If the underlying cause is a secondary condition — for example, rheumatoid arthritis (M06.9) driving the cartilage inflammation — sequence the primary condition first per ICD-10-CM sequencing guidelines and use M94.0 as an additional code.

Differentiate M94.0 from generic chest pain codes (R07.-) and thoracic spine pain (M54.6). M94.0 requires documented sternal or parasternal tenderness at the costochondral or costosternal junction — not just chest pain linked to breathing or thoracic spine movement. Slipped rib syndrome is also an approximate synonym indexed to this code.

Inclusion & exclusion notes

Per the official ICD-10-CM Tabular List.

Source · CDC ICD-10-CM Official Tabular List · 2026

Includes

Costochondritis

Sibling codes

Other billable codes under M94 (laterality / anatomic variants).

M94.1

Relapsing polychondritis

M94.9

Disorder of cartilage, unspecified

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Is costochondritis the same code as Tietze syndrome under ICD-10-CM?

Yes. ICD-10-CM maps both costochondritis and Tietze syndrome to M94.0 via the Applicable To annotation and the Alphabetic Index. The distinction — Tietze syndrome classically involves visible swelling, while costochondritis does not — is clinically meaningful but does not affect code assignment.

02Does M94.0 require a laterality digit?

No. M94.0 is a single five-character billable code with no laterality extension. Document left vs. right in the clinical note for medical necessity purposes, but the code itself does not differentiate side or rib level.

03When should I use R07.- instead of M94.0?

Use R07.- codes only when chest pain is the presenting symptom without a confirmed costochondritis or Tietze syndrome diagnosis. If the provider has documented costochondritis or reproducible costochondral tenderness consistent with Tietze syndrome, M94.0 is the correct code — do not default to a symptom code.

04Which CPT codes most commonly pair with M94.0 in an orthopedic setting?

Costosternal injection (20605 for intermediate joint/bursa) is a common procedural pairing. E/M codes (99213–99215) apply for office-based evaluation. Physical therapy procedures such as 97110 and 97140 also pair when conservative management is documented.

05What DRG does M94.0 group to, and why does that matter for facility coders?

M94.0 groups to MS-DRG 205 (with MCC) or 206 (without MCC) — Other Respiratory System Diagnoses — rather than a musculoskeletal DRG. Facility coders should be aware of this grouping when assessing expected reimbursement, as it may differ from other M94.- codes.

06If Tietze syndrome is secondary to rheumatoid arthritis, how do I sequence the codes?

Sequence the rheumatoid arthritis code (e.g., M06.9) as the principal or first-listed diagnosis, then add M94.0 as an additional code to capture the costochondral involvement. ICD-10-CM sequencing guidelines require the underlying condition to be listed first when a causal relationship is documented.

07Is slipped rib syndrome the same as M94.0?

Per the ICD-10-CM Alphabetic Index, slipped rib syndrome is an approximate synonym indexed to M94.0. However, if the provider's documentation clearly distinguishes a traumatic rib cartilage injury, review whether an injury code (S-category) or a more specific code is warranted before defaulting to M94.0.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

01CDC ICD-10-CM Tabular List 2026 (effective Oct 1, 2025)
02
icd10data.com
https://www.icd10data.com/ICD10CM/Codes/M00-M99/M91-M94/M94-/M94.0
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M94.0
04
icdcodes.ai
https://icdcodes.ai/icd10/M94.0
05
icdcodes.ai
https://icdcodes.ai/diagnosis/thorax-pain/documentation
06
cdek.pharmacy.purdue.edu
https://cdek.pharmacy.purdue.edu/icd10/M94.0/
07
cdc.gov
https://www.cdc.gov/nchs/icd/icd-10-cm/index.html

Mira AI Scribe

The Mira AI Scribe captures the specific rib level(s) involved, laterality, presence of palpable swelling, reproducibility of tenderness on physical exam, and any imaging or cardiac workup performed to rule out competing diagnoses. This documentation prevents downgrade to a non-specific chest pain code (R07.-) and eliminates the audit risk of assigning M94.0 without supporting clinical findings.

See how Mira captures M94.0 documentation