Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that the pain management (PM) specialist saw a patient in the office for pain from an implanted medical device. Are there ICD-10-CM codes specifically for this type of pain?

Washington Subscriber

Answer: Yes, there are diagnosis codes for pain due to medical devices. Check out this step-by-step guide to arriving at the right code for every patient, every time.

First, you’ll start with the T85.8- (Complications of other internal prosthetic devices, implants and grafts) codes. This set includes codes for all sorts of complications related to medical devices: embolism, fibrosis, hemorrhage, stenosis, thrombosis, and pain. You’ll select T85.84- (Pain due to internal prosthetic devices, implants and grafts, not elsewhere classified) as the 5-character base for the ICD-10-CM code.

Don’t stop there: Once you’ve settled on T85.84-, you’ll then choose an appropriate 6^th character based on whether the medical device was implanted into the nervous system (6^th character “0”) or another part of the body (6^th character “8”).

Then, you’ll choose a 7^th character for the diagnosis based on the encounter type. According to ICD-10-CM, “The appropriate 7^th character is to be added to each code from category T85.” The 7^th character choices are:

• A = initial encounter
• D = subsequent encounter
• S = sequela.

So, let’s say that a patient reports with pain related to a medical device implanted in their nervous system; it is the initial encounter for the injury with your PM provider. On the claim, you’d report T85.840A (Pain due to nervous system prosthetic devices, implants and grafts, initial encounter) as the diagnosis.

1 more thing: Check the encounter notes for an indication as to whether the pain was acute or chronic, because you should also add G89.18 (Other acute postprocedural pain) or G89.28 (Other chronic postprocedural pain) to the claim as a secondary diagnosis.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC