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Dx Coding ? Pain Mgmt

  1. #1
    Smile Dx Coding ? Pain Mgmt
    Medical Coding Books
    If a docotor indicates in his dictation notes that a patient presents with Herniated Cervical Disc (722.0) and experiences Radiculopathy (723.4) is correct to code both Dx's on claim form for this encounter? Or is the radiculopathy included in 722.0? Please help me with this. Thank You

  2. #2
    Sioux Falls South Dakota
    722.0 includes radiculitis. If you check the excludes note under 723, it excludes conditions due to intervertebral disc disorders (722.0 to 722.9). Therefore, on the example given, you would only code 722.0.

    I hope this helps.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  3. #3
    (These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

    If a causal relationship can be determined by the terminology used on the operative report (e. g. the herniated disk caused the radiculopathy), then the radiculopathy is not to be coded. If both dx are merely listed, then code them both. If you are not sure if a causal relationship has been established, then code them both. The only exception that I have run across is an issue with medical necessity. If the radiculopathy is required to meet medical necessity and the herniation does not meet medical necessity, and even though there has been a causal relationship established, I would code the radiculopathy in order to get paid.

    Richard Mann, your pain management coder

  4. #4
    I totally agree with Richard. We use both codes if given for Radiology.

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