Anesthesia Coding Alert
Begin in S13 Code Family for Neck Sprain Diagnosis
Question: My pain management specialist treated a patient who was complaining of neck pain. The encounter notes indicated that the patient’s final diagnosis was a neck sprain. Which ICD-10-CM code should I report for this procedure and encounter? New Jersey Subscriber Answer: You may need a little bit more information to select the most accurate code. First, you’ll need to find out which ligaments/ joints were sprained in the neck. Your options include: Note: Each of these codes requires a seventh character to note the encounter status: A (Initial encounter), D (Subsequent encounter), or S (Sequela). So, if the notes indicate that a patient presents with neck pain for the first time, and the provider diagnoses a sprain of the cervical spine ligaments, you’d report S13.4xxA for the encounter. You may also add a code from Chapter 20 to describe how the neck sprain happened, if known (such as, W06.xxxA, Fall from bed, initial encounter).
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