Patient presents with complaint of rib pain.  Onset, duration, location, character, aggravating factors, and relieving factors of the rib pain were thoroughly explored.  Differential diagnosis includes intercostal muscle strain, costochondritis, rib fracture, pleurisy, pneumonia, herpes zoster (shingles), and chest wall tumors.  Patient reports experiencing localized right-sided rib cage pain for the past three days.  The pain is described as sharp and stabbing, exacerbated by deep breathing, coughing, and movement.  Pain is somewhat relieved by rest and over-the-counter analgesics like ibuprofen.  Physical examination reveals point tenderness along the fifth rib at the mid-axillary line.  No crepitus, swelling, or ecchymosis noted.  Lung sounds are clear to auscultation bilaterally.  Based on the patient presentation and physical examination findings, the initial diagnostic impression is intercostal muscle strain.  Plan includes conservative management with rest, ice, and NSAIDs.  Patient education provided on proper body mechanics and pain management techniques.  Follow-up scheduled in one week to assess response to treatment.  If symptoms worsen or do not improve, further diagnostic testing, such as chest x-ray to rule out rib fracture or other pathology, may be considered.  ICD-10 code M79.18 for other intercostal neuralgia is provisionally assigned, pending further evaluation.  Medical necessity for the encounter is established.