Wiki ICD-10 and pain management

Community Wiki

This is a community-maintained wiki post containing the most important information from this thread. You may edit the Wiki once you have been on AAPC for 30 days and have made 5 posts. Learn More
G
Code: R52

Code Name: ICD-10 Code for Pain, unspecified

Block: General symptoms and signs (R50-R69)

Details: Pain, unspecified

Acute pain NOS
Generalized pain NOS
Pain NOS

Excludes 1: acute and chronic pain, not elsewhere classified (G89.-)
localized pain, unspecified type - code to pain by site, such as:abdomen pain (R10.-)
back pain (M54.9)
breast pain (N64.4)
chest pain (R07.1-R07.9)
ear pain (H92.0-)
eye pain (H57.1)
headache (R51)
joint pain (M25.5-)
limb pain (M79.6-)
lumbar region pain (M54.5)
pelvic and perineal pain (R10.2)
shoulder pain (M25.51-)
spine pain (M54.-)
throat pain (R07.0)
tongue pain (K14.6)
tooth pain (K08.8)
renal colic (N23)
pain disorders exclusively related to psychological factors (F45.41)

Guidelines: Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)

Note: This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
The conditions and signs or symptoms included in categories R00-R94 consist of:
(a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
(b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
(c) provisional diagnosis in a patient who failed to return for further investigation or care;
(d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
(e) cases in which a more precise diagnosis was not available for any other reason;
(f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

Excludes 2: abnormal findings on antenatal screening of mother (O28.-)
certain conditions originating in the perinatal period (P04-P96)
signs and symptoms classified in the body system chapters
signs and symptoms of breast (N63, N64.5)

For more details on R52 , ICD-10 Code for Pain, unspecified , visit: https://coder.aapc.com/icd-10-codes/
Messages
4
Best answers
0
I have coded many specialties but I have never coded for anesthesiology. I know a pain management physician who is pretty clueless about ICD-10. He is in a small practice and I am assuming they contract out their billing. I offered to get him some basic information about how ICD-10 will specifically impact his practice. I am just looking for a couple of diagnosis example specific to pain management. I work for a prominent University and am the billing supervisor of one of the largest ER's in the country so we have been preparing for quite some time. I know how ICD-10 will affect ER codes and have been educating our physicians. I am just not familiar with pain management coding and am looking for diagnosis examples specific to pain management billing. I would appreciate any input. Thanks.
 

mitchellde

True Blue
Messages
13,390
Location
Columbia, MO
Best answers
1
The ICD-9 code category that was created specifically for pain management is 338, the ICD-10 CM category is G89. These are identical in nomenclature and the the guidelines are identical. I suggest reading the pain guidelines from either set as they are very well written and easy to understand.
 

hgolfos

Guru
Messages
206
Location
Montgomery, Alabama
Best answers
0
Diagnoses that he uses often should be reviewed in ICD-10 as many code sets have been expanded and require more detailed documentation. For instance, spinal stenosis has been expanded in great detail. The code-set in ICD-9 consists of 6 codes, but in ICD-10 it is code-set M99 which includes more than a page's worth of codes. Fracture coding is another area that has been greatly expanded. I would also recommend that he take some kind of physician training course.
 

ardellt

Networker
Local Chapter Officer
Messages
29
Location
Menasha, Wisconsin
Best answers
0
Here is some ICD documentation info I have shared with our pain providers:
1)RSD(CRPS type I) or Causalgia(CRPS type II)-list RT, LT or Bilateral and upper or lower extremities.
2) Muscle spasm-list body area
3) Bursitis-list joint and LT or RT
4) Lumbago with sciatica-list LT or RT
5) Abdominal pain-indicate site and chronic or acute
6) Osteoporosis-with or without current fracture- localized, age related or drug induced. If with current fracture list site of fracture
7) Joint Pain-cannot state multiple, need to list out all joints and LT/RT
8) Lower Limb/leg Pain-Toe, foot, lower leg or thigh-LT or RT
9) Upper Limb/arm Pain-finger, hand, forearm, upper arm and axilla-LT/RT
10) Spondylosis-indicate with or without myelopathy and/or radiculopathy
11)Spinal Stenosis-indicate location
Occipito-atlanto-axial region-M48.01
Cervical region-M48.02
Cervicothoracic region-M48.03
Thoracic region-M48.04
Thoracolumbar region-M48.05
Lumbar region-M48.06
Lumbosacral region-M48.07
Sacral/sacrococcygeal region-M48.08
Site unspecified-M48.00-some insurance will not pay unspecified codes
 
Top