Pain Management Coding Alert
Use 'Other' Classification for this Spondylopathy
Question: The PM specialist performs a level-two evaluation and management (E/M) service for an established patient with spondylopathy. They type of spondylopathy, however, isn't so clear. The notes state "post-long ligament ossified." Can you make any sense of that note? Wisconsin Subscriber Answer: While it would always be best to check with the performing PM specialist, this diagnosis will likely come from the M48.8X- (Other specified spondylopathies) code set. Explanation: The ICD-10 entry for M48.8X- includes the description: "Ossification of posterior longitudinal ligament." Based on the provider's notes, this sounds like the right code set. You'll still need more info, however, before choosing the correct ICD-10 code for your 99212 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making ...) encounter. Do this: Check with the provider to see if you should be using the M48.8X- code set. Also, ask him about the anatomy of the spondylosis. Then, choose the best ICD-10 code from the following to append to 99212:
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