EM Coding Alert
Choosing Acute or Chronic Dx
Question: For diagnosis coding purposes, what is the difference between acute and chronic pain? Notes indicate that the physician performed a level-three E/M service for an established patient with complaints of severe pain. I don’t know how to report the ICD-10 code for the patient’s pain. Can you help me select the proper ICD-10 code for this encounter?
West Virginia Subscriber
Answer: You’ll have to get answers to a few more questions before deciding which ICD-10 code to report with 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity).
Check out this advice on the basics of ICD-10 coding for acute and chronic pain. Then, go back to the encounter form to dig for any more specifics regarding the patient’s pain. If you’re unable to ferret out the proper diagnosis after these steps, go back to the physician and ask for any details you need to complete the claim.
Acute pain basics: Acute pain typically lasts between three and six months. Acute pain can be directly related to tissue damage or associated with a recent accident, injury or surgery.
Acute pain ICD-10 codes: Codes that you’ll use for acute pain diagnoses include:
Chronic pain basics: Unlike acute pain’s more temporary nature, chronic pain is ongoing; a patient suffers chronic pain for six months or more. Patients with chronic pain could have an identifiable pain generator, such as an injury, or they might have no identifiable pain generators.
Chronic pain ICD-10 codes: Codes that you’ll use for acute pain diagnoses include:
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