Neurology & Pain Management Coding Alert

Question: My neurologist often documents -neuropathic pain- as the patient's primary diagnosis. How should I code this?

Nevada Subscriber

Answer: The International Association for the Study of Pain defines neuropathic pain as pain initiated or caused by a primary lesion or dysfunction in the nervous system. Patients may feel neuropathic pain as a burning or tingling sensation or as hypersensitivity to touch or cold. You have three options when coding for neuropathic pain.

You might find an appropriate diagnosis in the codes related to causalgia, such as 354.4 (Causalgia of upper limb), 355.7x (Other mononeuritis of lower limb), 355.8 (Mononeuritis of lower limb, unspecified) or 355.9 (Mononeuritis of unspecified site).

Other options include coding by the -cause- of the patient's pain. These could include phantom limb pain (353.6), postherpetic neuralgia (which you code by site), or reflex sympathetic dystrophy (337.2x).

Third, you can report a more general diagnosis such as 729.2 (Neuralgia, neuritis, and radiculitis, unspecified). 

Because you have so many options for coding neuropathic pain, talk with your physician to determine the best diagnosis for the case.