Advanced Search

Primary Care Coding Alert

READER QUESTIONS:

Garner Specifics for Chronic Pain Diagnosis

Published on Sun May 21, 2006

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.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Primary Care Coding Alert

View All