Low Back Pain dx help

PLAIDMAN

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I am confused about this code 724.2. My doc wants all her back pain cases to reflect the 724.2 code, however, I was under the impression that if a more definitive dx is given...724.4 ; 722.10 ; 724.02 etc....then you should use the more specific dx.

Do you still put 724.2 on claim even if you are giving the more specific dx of the problem? I know the 722.10 includes low back pain so I do not normally code the 724.2 with it??

Any thoughts would help out, thanks
 

jmcpolin

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I would code the more definitive code such as herniated disc, degenerative disc disease, spondylosis or whatever and code the back pain if nothing else is found.
 

mitchellde

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read the coding guidelines for use of the pain codes (338.xx) If the visit is for pain management or pain control then you use the 338.xx codes for acute or chronic pain but the provider must document acute or chronic status, you may also code secondary the condition causing the pain. This guideline over rides the guideline that states you do not code the symptom with the definitive. You can when one of them is acute or chronic pain.
 

shruthi

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Many a times insurance likes to see the symptoms, so you can bill LBP as PDx followed by other diagnosis. We are following the same in one of our client.
Despite of other definitive diagnosis, we are instructed to code the symptoms as PDx for better reimbursement.
 

mitchellde

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Many a times insurance likes to see the symptoms, so you can bill LBP as PDx followed by other diagnosis. We are following the same in one of our client.
Despite of other definitive diagnosis, we are instructed to code the symptoms as PDx for better reimbursement.
Codes should not be appended just based on how they reimburse, rather based on documentation and coding guidelines. The guidelines state that unless a chapter specific guideline states otherwise you do not code the symptom. Also the exclude notes must be adhered to.
 

tmlbwells

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You can use the pain as a secondary diagnosis, but you need to code to the highest specificity. The pain would be a symptom of whatever the findings are.
 
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