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ED Coding and Reimbursement Alert

Reader Questions:

Go Straight to Source for Pain Code

Published on Mon Jan 09, 2006

Question: A patient came in to the ED with a chief complaint of -dental wire poking into his lip.- After the physician examined him and discharged him with the instruction -Follow up with dentist and get some wax from the drug store,- the physician didn't perform any further treatment. The final diagnosis on the chart: Dental hardware pain. What diagnosis code should I report for this?


Texas Subscriber
Answer: Your best option in this scenario is simply to bill out with a diagnosis for mouth pain (or lip or gum, if somewhere in the chart it indicates exactly what the hardware was poking). Yes, the physician stated -dental hardware pain,- but the hardware doesn't hurt -quot; the patient's mouth hurts because of the hardware. So, you could follow up the pain code with either a -postprocedural complication code- or a relevant E code, whichever better fits your practice's preference.
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