Neurosurgery Coding Alert

Question: My physician often claims "chronic pain" as a diagnosis, but I can find no mention of this in ICD-9. Which code should I use?

Illinois Subscriber

Answer: If you consult ICD-9's alphabetical index, you'll notice a fairly 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. A new code for generalized pain (780.99) has been added for 2003, but rather than rely on this diagnosis, you should ask the physician to pinpoint the location of the pain and code accordingly.

For example, a patient with back pain might 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.