Introduction
According to the National Institutes of Health (NIH), approximately 2 million acute ankle sprains occur annually in the United States, making ankle-related injuries one of the most common musculoskeletal presentations in both outpatient and emergency care settings. Left ankle pain, in particular, may arise from trauma, repetitive stress, arthritis, or systemic inflammatory conditions and demands accurate clinical evaluation and documentation.
For coding professionals, the proper use of ICD-10 code for left ankle pain (M25.572) plays a critical role in claim accuracy, audit defense, and payer compliance. This guide provides a detailed overview of when and how to report M25.572 correctly, including clinical use cases, documentation standards, and billing considerations aligned with current regulatory expectations.
What You’ll Learn
- The official ICD-10 code for left ankle pain
- When and how to use M25.572
- Tips for supporting documentation
- Common coding mistakes to avoid
- Differences between pain, injury, and chronic conditions
- Relevant CPT codes and modifiers
- When to use symptom vs. definitive diagnosis codes
What Is Left Ankle Pain?
Left ankle pain refers to discomfort, aching, or soreness localized in the left ankle joint and surrounding structures including bones, ligaments, tendons, cartilage, and nerves. It can result from acute injuries, chronic overuse, systemic conditions, or referred pain from other areas.
This pain may develop suddenly (e.g., due to a sprain or fracture) or gradually over time (e.g., arthritis, tendinitis, or nerve compression). It can be mild to severe, and may affect mobility, balance, and daily activities like walking, standing, or exercising.
Common Causes of Left Ankle Pain
- Sprains and ligament injuries
- Tendonitis or overuse syndromes
- Fractures or bone bruises
- Arthritis (e.g., osteoarthritis, rheumatoid arthritis)
- Achilles tendinopathy
- Bursitis
- Nerve entrapment (e.g., tarsal tunnel syndrome)
- Gout or pseudogout
- Post-surgical or post-traumatic complications
ICD-10 Code for Left Ankle Pain: M25.572
- Code: M25.572
- Description: Pain in left ankle and joints of left foot
- Category: M25.57—Pain in ankle and joints of foot
- Billable: Yes
- Code Type: Specific diagnosis code for symptom-based reporting
ICD-10-CM Structure Breakdown:
| Code Component | Meaning |
|---|---|
| M | Diseases of the musculoskeletal system and connective tissue |
| 25 | Other joint disorders, not elsewhere classified |
| 57 | Pain in ankle and joints of foot |
| 2 | Left side (specific to left ankle and joints of left foot) |
When to Use ICD-10 code for left ankle pain (M25.572)
Use M25.572 when the patient presents with pain in the left ankle or associated joints in the left foot, and no specific underlying condition is diagnosed yet. This typically includes:
- Acute ankle sprains (without a confirmed tear)
- Overuse injuries or repetitive strain symptoms
- Early arthritis without radiologic confirmation
- Pain after minor trauma with no fracture or ligament tear
- Nonspecific ankle joint pain under investigation
Documentation Requirements for M25.572
Clinical Example
Case Study:
Patient presents with a 2-day history of left ankle pain after stepping off a curb awkwardly. No swelling or bruising noted. ROM mildly restricted. Provider suspects minor ligament strain but no imaging performed yet.
Appropriate ICD-10 code for left ankle pain (M25.572)
Justification: Specific left ankle pain without confirmed structural injury.
Related ICD-10 Codes to Avoid Confusion ICD-10 Code Description Use When
| ICD-10 Code | Description | Use When |
|---|---|---|
| M25.571 | Pain in right ankle | Pain is isolated to the right side |
| M25.579 | Pain in unspecified ankle | Side is not documented (use only if truly unknown) |
| S93.402A | Sprain of unspecified ligament of left ankle, initial encounter | Confirmed sprain injury present |
| M79.672 | Pain in left foot | Pain is in foot, not ankle or joint-related |
CPT Codes Commonly Billed with M25.572
If you’re coding for services performed due to left ankle pain, here are common CPT codes that may be used alongside M25.572:
| CPT Code | Description |
|---|---|
| 73600 | X-ray ankle, 2 views |
| 99213 | Office visit, established patient, moderate complexity |
| 20552 | Injection(s); trigger point(s), 1 or 2 muscle(s) |
| 97110 | Therapeutic exercises (used in PT settings) |
Left Ankle Pain vs. Injury: Know the Difference
One of the most common errors in coding ankle-related conditions is confusing symptom codes (like M25.572) with injury or definitive diagnosis codes (like S93.402A or M19.072 for osteoarthritis).
Here’s a quick rule of thumb:
| 📍 Scenario | Use Symptom Code (M25.572)? | Use Injury/Disease Code? |
|---|---|---|
| Pain without diagnosis | ✅ Yes | ❌ No |
| Confirmed sprain/fracture | ❌ No | ✅ Yes |
| Ongoing arthritis with imaging | ❌ No | ✅ Yes |
| First-time complaint under evaluation | ✅ Yes | ❌ No |
Modifier Tips (For Procedural Coding)
What Are Modifiers?
Modifiers are two-digit codes added to CPT/HCPCS procedure codes to give extra information about the service. They help clarify the circumstances of a procedure so payers don’t deny or underpay your claim.
If you’re billing procedures or therapy linked to ICD-10 code for left ankle pain (M25.572), ensure you use proper modifiers for clarity:
| Modifier | When to Use |
|---|---|
| LT | Procedures performed on the left ankle (e.g., injections) |
| 25 | Significant, separately identifiable E/M service on same day |
| 59 | Distinct procedural service when bundling may apply |
How Payers View Ankle Pain Codes
Commercial and government payers scrutinize symptom-based codes like M25.572 for medical necessity and supporting documentation. They expect to see:
- Laterality (left side confirmed in documentation)
- Clear clinical indication for tests or procedures
- Follow-up plan for determining the root cause
Using M25.572 repeatedly across visits without diagnostic progress may raise red flags.
Pro-MBS: Technical Accuracy in Left Ankle Pain Coding
Our Pro-MBS team specializes in translating clinical documentation into precise, payer-accepted claims. For symptom-based conditions like left ankle pain, the use of ICD-10 code M25.572 requires more than basic coding knowledge. Our certified coding team ensures that laterality, symptom duration, and clinical context are fully captured and compliant with current CMS and commercial payer standards minimizing denials and improving audit readiness.
We partner with orthopedic, podiatry, and outpatient care providers to strengthen musculoskeletal coding workflows across the revenue cycle. From front-end documentation audits to claim-level validation, Pro-MBS ensures every encounter is coded accurately, billed correctly, and fully supported for reimbursement. If you're seeing high denial rates tied to non-specific or symptom-only codes, our team can help resolve the root cause and optimize performance.
