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Pain management guidelines ICD10?

  1. #1
    Location
    Gainesville, GA
    Posts
    25
    Question Pain management guidelines ICD10?
    Medical Coding Books
    Help!
    Can anyone make sense of the chapter 6 guidelines for pain? I interpret them to say that if a physician is treating for pain control then the primary diagnosis is G89.29 (Other chronic pain). OK, but then under sequencing, if the specific site is known, then you code pain for that site along with chronic pain?
    What about injections?
    Confused

  2. #2
    Default
    per chapter 6a guideline when pain control is the reason for encounter for injection. the underlying cause of the pain should be reported as an additional dx if know however in the guidelines of chapter 6 it doesn't state to use additional code for injection I am assuming to code for injection would be to use CPT for what type of injection.

  3. #3
    Location
    Gainesville, GA
    Posts
    25
    Default
    Thank you. This is the way I understood them, but my physicians do not agree.

  4. Default I am really confused with G vs M CODES
    I do work for a pain mgmt practice and the chapter is very specific and even give examples of when patient will have the Epidural to treat the pain not to target the issue, so I assume that the doctors are doing epidurals and MBBs, etc to reduce pain and not to cure the cause of pain, so this is diagnosis and has nothing to see with CPT CODES. however my Doctor stated that if we bill for Chronic pain G89.29 the bills are going to be denied.

    any clarification??? when to use G or M diagnosis ???

  5. #5
    Location
    Columbia, MO
    Posts
    12,821
    Default
    If you read the pain guidelines you will see that you use both the G and the M codes. If you know the underlying cause of the pain and the encounter is for pain management then assuming the provider documents the pain as acute or chronic, you sequence the G89 code first, and the code for the cause of the pain secondary. If the cause is not know but the site of the pain is documented such as chronic low back pain, you sequent the G89 code first and the code for the site specific secondary
    Last edited by mitchellde; 10-29-2015 at 07:36 PM.

    Debra A. Mitchell, MSPH, CPC-H

  6. Question Questions
    Coding with modifier 25
    I am confused if you have a 99214 and Go434qw, is modifier 25 accurate?

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