Neurology & Pain Management Coding Alert

Question: Our neurologist saw an emergency department (ED) patient who complained of migraine pain. After examining the patient, our physician believed the patient was trying to get a pain medication prescription. What diagnosis should I report?


New York Subscriber


Answer: Coders offer many suggestions for a diagnosis in this case, including V65.5 (Person with feared complaint in whom no diagnosis was made), 784.0 (Headache) or 346.9x (Migraine, unspecified) (if the physician actually diagnosed a headache or migraine).

If your neurologist truly believes the patient is faking the illness to obtain medication, go for the hard-hitting diagnosis: V65.2 (Person feigning illness).

Document it: If your physician really believes the patient is seeking drugs, he should flag the patient's chart for future reference.