Primary Care Coding Alert
Garner Specifics for Chronic Pain Diagnosis
Question: Which diagnosis should I report for chronic pain?
California Subscriber
Answer: The term -chronic pain- means the patient has experienced the pain condition for more than three months. Seeing this term on a chart makes your job more difficult because it's so general.
Some coders recommend reporting 780.99 (Other general symptoms) in this situation, but other coders balk at using such a nonspecific descriptor. A diagnosis such as 729.1 (Myalgia and myositis, unspecified) could work if the patient has chronic muscle pain and meets the criteria for fibromyalgia.
Ideally, your physician will give you more information so you can code according to the site of pain (such as 724.2, Lumbago, for low back pain).
Encourage your physicians to document more specific diagnoses so you-ll have the details to ensure accurate coding. Asking questions such as -Where is the patient's pain?- or -What hurts?- helps you narrow your coding choices.
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Question: Which diagnosis should I report for chronic pain?
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