Anesthesia Coding Alert

ICD-10 Update:

Zero in on More Specific Diagnoses for Low Back Pain

Look ahead to code changes in October.

Fall brings cooler weather and changing leaves – and, for the coding world, updated ICD-10-CM diagnosis codes. The World Health Organization (WHO) has released its latest list of ICD-10 codes that will go into effect on Oct. 1, 2021.

The rundown: According to the WHO, the new code book will have:

  • 191 new ICD-10 codes,
  • 27 revised ICD-10 codes, and
  • 25 deleted codes (though none apply to pain management).

Read on for sneak peek at new diagnoses you might need when you code for pain management.

Explore New Back Pain, Headache Codes

Dorsalgia, or low back pain, is such a common diagnosis that any new additions to the code family are welcome since they’ll help you code more accurately. The new edition of ICD-0-CM will include three new diagnoses related to low back pain:

  • M54.50 (Low back pain, unspecified)
  • M54.51 (Vertebrogenic low back pain)
  • M54.59 (Other low back pain).

Headache: The new G44.86 (Cervicogenic headache) code will allow you to code cervicogenic headache when the provider diagnoses it. Under past editions of ICD-10-CM, you were forced to code cervicogenic headaches with a less specific code from the G44.8 (Other specified headache syndromes) code set.

You also should be familiar with new Sjogren syndrome codes as potential secondary diagnoses:

  • M35.05 (Sjogren syndrome with inflammatory arthritis)
  • M35.06 (Sjogren syndrome with peripheral nervous system involvement)
  • M35.07 (Sjogren syndrome with central nervous system involvement)
  • M35.08 (Sjogren syndrome with gastrointestinal involvement)
  • M35.0A (Sjogren syndrome with glomerular disease)
  • M35.0B (Sjogren syndrome with vasculitis)
  • M35.0C (Sjogren syndrome with dental involvement)

Here’s why: At first glance, it doesn’t seem that Sjogren syndrome would be relevant to neurology or pain management coders; the condition is marked by dry eyes and dry mouth, which won’t be treated by any of your providers. You will, however, probably see people with rheumatoid arthritis (RA), inflammatory arthritis, or peripheral/central nervous system issues. These patients often suffer from Sjogren syndrome due to their primary conditions, so these could be frequent secondary diagnoses for some of your patients.

Other code additions almost double the coding options you’ll have for the M45 (Ankylosing spondylitis) code set. The new diagnoses are:

  • M45.A (Non-radiographic axial spondyloarthritis)
  • M45.A0 (Non-radiographic axial spondyloarthritis of unspecified sites in spine)
  • M45.A1 (Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region)
  • M45.A2 (Non-radiographic axial spondyloarthritis of cervical region)
  • M45.A3 (Non-radiographic axial spondyloarthritis of cervicothoracic region)
  • M45.A4 (Non-radiographic axial spondyloarthritis of thoracic region)
  • M45.A5 (Non-radiographic axial spondyloarthritis of thoracolumbar region)
  • M45.A6 (Non-radiographic axial spondyloarthritis of lumbar region)
  • M45.A7 (Non-radiographic axial spondyloarthritis of lumbosacral region)
  • M45.A8 (Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region)
  • M45.AB (Non-radiographic axial spondyloarthritis of multiple sites in spine).


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