Neurology & Pain Management Coding Alert

Reader Question:

Scan ICD-9 for an Appropriate Pain Diagnosis

Question: One of our neurologists often cites "chronic pain" as a diagnosis, but I can find no mention of this in ICD-9. Which code(s) is appropriate? Illinois Subscriber Answer: If you consult ICD-9's alphabetical index, you'll notice a long and inclusive list of "pain" diagnoses, but nothing for "chronic" or "intractable" pain. Rather, the diagnoses tend to specify an anatomic area, such as "abdominal," "face" or "neck." CMS added a new code for generalized pain (780.99) for 2003, but rather than rely on this diagnosis, you should ask the physician to pinpoint the pain's location. For example, a patient with back pain may describe the discomfort as arising from the lower back (724.2), coccyx (724.79) or thoracic region (724.1). Remember, always code to the highest level of specificity that the physician can determine accurately. Doing so will allow for better patient care and ease claims' payment. Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.  
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Neurology & Pain Management Coding Alert

View All