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Thread: ICD-10 and pain management

  1. #1

    Smile ICD-10 and pain management

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    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.

  2. #2
    Join Date
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    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.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3

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    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.

  4. #4
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    Apr 2007
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    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

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