Pain Management Coding Alert

Published on Mon Jun 30, 2014 PDF

Check out your expanded options, beginning October 2015.

When your pain management specialist administered injections to treat carpal tunnel syndrome (20526, Injection, therapeutic [e.g., local anesthetic, corticosteroid], carpal tunnel) you have several diagnosis options, based on the patient’s situation. Take a quick glance at how these diagnosis codes will transition under ICD-10 in October 2015.

Possibility 1: Current code 719.4x (Pain in joint) will become more specific in ICD-10 to indicate where the patient experiences pain in the wrist. The ICD-10 codes are as follows:

• M25.539 (Pain in unspecified wrist)
• M25.531 (Pain in right wrist)
• M25.532 (Pain in left wrist).

Possibility 2: ICD-9 code 729.5 (Pain in limb) will become M79.6x (Pain in limb, hand, foot, fingers and toes …) and explode with a range of options based on anatomic site. The extended codes provide you with 30 options, including right, left and unspecified sites of arm (M79.601-603); forearm (M79.631-632, 639); upper arm (M79.621-622, 629); hand (M79.641-43); fingers (M79.644-646); thigh (M79.651-52,659); leg (M79.604-605); lower leg (M79.661-662,669); feet (M79.671-673); and toe (M79.674-76). You’ll report M79.609 for pain in an unspecified limb.

Possibility 3: Diagnosis 728.87 (Muscle weakness [generalized]) will be an easy one to remember because it will retain the same descriptor with M62.81. 

Final note: Under ICD-9, diagnosis 354.0 (Carpal tunnel syndrome) is coupled with mononeuritis of upper limb and mononeuritis multiplex. The ICD-10 system will offer more clarity with separate codes for unspecified upper, right, and left limbs, as follows:

• G56.00 (Carpal tunnel syndrome, unspecified upper limb)
• G56.01 (Carpal tunnel syndrome, right upper limb)
• G56.02 (Carpal tunnel syndrome, left upper limb).