Pain Management Coding Alert

Check out your expanded options, beginning October 2015.

When your pain management specialist administered injections to treat carpal tunnel syndrome (20526, Injection, therapeutic [e.g., local anesthetic, corticosteroid], carpal tunnel) you have several diagnosis options, based on the patient’s situation. Take a quick glance at how these diagnosis codes will transition under ICD-10 in October 2015.

Possibility 1: Current code 719.4x (Pain in joint) will become more specific in ICD-10 to indicate where the patient experiences pain in the wrist. The ICD-10 codes are as follows:

• M25.539 (Pain in unspecified wrist)
• M25.531 (Pain in right wrist)
• M25.532 (Pain in left wrist).

Possibility 2: ICD-9 code 729.5 (Pain in limb) will become M79.6x (Pain in limb, hand, foot, fingers and toes …) and explode with a range of options based on anatomic site. The extended codes provide you with 30 options, including right, left and unspecified sites of arm (M79.601-603); forearm (M79.631-632, 639); upper arm (M79.621-622, 629); hand (M79.641-43); fingers (M79.644-646); thigh (M79.651-52,659); leg (M79.604-605); lower leg (M79.661-662,669); feet (M79.671-673); and toe (M79.674-76). You’ll report M79.609 for pain in an unspecified limb.

Possibility 3: Diagnosis 728.87 (Muscle weakness [generalized]) will be an easy one to remember because it will retain the same descriptor with M62.81. 

Final note: Under ICD-9, diagnosis 354.0 (Carpal tunnel syndrome) is coupled with mononeuritis of upper limb and mononeuritis multiplex. The ICD-10 system will offer more clarity with separate codes for unspecified upper, right, and left limbs, as follows:

• G56.00 (Carpal tunnel syndrome, unspecified upper limb)
• G56.01 (Carpal tunnel syndrome, right upper limb)
• G56.02 (Carpal tunnel syndrome, left upper limb).