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Acute and chronic pain codes

  1. Default Acute and chronic pain codes
    Medical Coding Books
    Is there a rule regarding where the acute or chronic pain codes go in the DX line up? Example: acute abd pain - should it be coded 789.00 then 338.19 or 338.19 then 789.00? I have always coded 338 code last but recently saw it coded first. Any help is appreciated!

  2. #2
    Columbia, MO
    The guidelines state that when the reason for the encounter is pain control/management, then the 338.- codes go first.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default Acute and chronic pain
    I was taught that if pain is a symptom of the underlying dx, then you would not code pain. You would code only the underlying dx.
    My ICD-9 book has exclusions listed under 338 "localized pain, unspecified type - code to pain, by site"
    If pain control is the reason for the encounter, then I would code Pain (338).

  4. #4
    SA Local Chapter
    Thumbs up Acute and chronic pain codes
    mitchellde is absolutely right if the encounter is for pain control or pain management, assign code from category 338, but if the encounter is for any other reason except pain control or pain management, and a related definitive diagnosis has not been established(confirmed) by the provider, assign the code for the specific site of pain first, followed by the appropriate code from category 338.

    FYI: Read: Chapter 6.a.ii 2nd bullet - Pain-Category

  5. Default
    Thanks everyone....that clears it up

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