Pain Management Coding Alert

Caveat: Extended bridge codes could be your best choice in some situations.

When your physician diagnoses lumbar spinal stenosis, you currently have two coding options based on whether the patient exhibits neurogenic claudication: 724.02 (Spinal stenosis, lumbar region; without neurogenic claudication) or 724.03 (… with neurogenic claudication).

ICD-10 change: The basic code switch when ICD-10 becomes effective in October will be simple. Both current codes 724.02 and 724.03 initially map to M48.06 (Spinal stenosis, lumbar region).

Don’t miss: When you search ICD-10 crosswalks, you’ll see that the results for 724.02 also include several extended code options:

• M48.07 – Spinal stenosis, lumbosacral region
• M99.23 – Subluxation stenosis of neural canal of lumbar region
• M99.33 – Osseous stenosis of neural canal of lumbar region
• M99.43 – Connective tissue stenosis of neural canal of lumbar region
• M99.53 – Intervertebral disc stenosis of neural canal of lumbar region
• M99.63 – Osseous and subluxation stenosis of intervertebral foramina of lumbar region
• M99.73 – Connective tissue and disc stenosis of intervertebral foramina of lumbar region.

Coding tip: These extended bridge options illustrate the range of specific codes that relate to the original ICD-9 code (724.02). You might have times when one of these codes would be more appropriate than M48.06, depending on the patient’s situation and your physician’s ocumentation.

“Providers can focus on adding this type of specificity to their current documentation to ease the transition in October,” says Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CPCO, owner of MJH Consulting in Denver, Co. “This type of information is frequently known by the provider, just not documented.”