# Post Stroke Pain Syndrome



## susanwarth (Apr 14, 2010)

Does anyone know the correct dx code to use for Post Stroke Pain Syndrome? Any help would be appreciated!!


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## m.j.kummer (Apr 14, 2010)

*susanwarth - Post Stroke Pain Syndrome*

My first thought is either 338.29 but let's look at it because you have more information than I do.

First, is it chronic pain?

Chronic pain
•  Pain that continues for longer than expected.
•  Pain that can range from mild to severe, and persists or progresses over a long period of time.
•  Pain which has persisted over a long period of time; also use NTs for specific types of pain if appropriate.
•  Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain); sudden or slow onset of any intensity from mild to severe, constant or recurring without an anticipated or predictable end and a duration of greater than 6 months.

When you look it up in the ICD-9 book you get these choices.

Pain(s) (see also Painful) 780.96
•  chronic 338.29
    o  associated with significant psychosocial dysfunction 338.4
    o  due to trauma 338.21
    o  postoperative 338.28
    o  post-thoracotomy 338.22
    o  syndrome 338.4

Which can lead you to 338.4 Chronic Pain Syndrome
Definition of Chronic Pain Syndrome
Chronic pain syndrome consists of chronic anxiety and depression, anger, and changed lifestyle, all with a variable but significant level of genuine neurologically based pain.

338.29 Other chronic pain
338.4  Chronic Pain Syndrome

It seems that one of these would be appropriate and without more information I lean toward 338.29.  However, having had a stroke the patient most certainly could have any of the symptoms listed in the definition of Chronic Pain Syndrome.


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## gaponte (Apr 14, 2010)

According to ICD-9 Coding Guidelines category 338 should not be used if the pain is not specified as chronic or acute (except postoperative and central pain syndrome). 

Therefore, I will use codes 438.89 (Stroke Late effect NEC), 780.96 (Pain NOS). However, if the documentation states "Post Stroke Chronic Pain Syndrome" I will use codes 438.89, 338.4 instead. 

I hope this helped you out,


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## susanwarth (Apr 15, 2010)

Thank you for your help - I appreciate it!!


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