Nov 09, 2021 · The generalized ICD 9 code for pain is 780.96, and additional codes were added to the ICD 9 in 2007 for postoperative pain, central pain syndrome and post thoracotomy pain. In the past, the codes for pain were included in the body systems and symptoms chapters.
2013 ICD-9-CM Diagnosis Codes 338.*. : Pain, not elsewhere classified. 338 Pain, not elsewhere classified. 338.0 Central pain syndrome convert 338.0 to ICD-10-CM. 338.1 Acute pain. 338.11 Acute pain due to trauma convert 338.11 to ICD-10-CM. 338.12 Acute post-thoracotomy pain convert 338.12 to ICD-10-CM.
Disclaimer: The information here is NOT meant to replace the sound advice of a billing and coding expert.. Below is a list of the most common ICD-9 codes (diagnosis codes) used in a physical medicine & rehabilitation (PM&R) and Spine pain management clinic.. For ICD-10 CODES, please go to this separate page. The most common codes I use are highlighted in blue.
These codes were created because ICD-9-CM did not have specific codes for encounters for pain management or for these specific types of pain. In addition to specific codes for post-thoracotomy pain and postoperative pain, there is a specific code for neoplasm-related pain (338.3). Generalized pain is coded to 780.96.
ICD10 Code (*) | Code Description (*) |
---|---|
R52 | Pain, not elsewhere classified |
R52.0 | Acute pain |
R52.00 | Acute pain |
R52.1 | Chronic intractable pain |
Documentation is the key to the correct code assignment when coding these conditions. Several of the codes are similar but vary slightly. Code 338.0 describes central pain syndrome; 338.4, Chronic pain syndrome; and 338.29, Other chronic pain. These conditions are different, and code assignments are based upon physician documentation.
With the creation of the new codes, guidelines related to these codes were added to the ICD-9-CM Official Guidelines for Coding and Reporting, effective November 15, 2006. A thorough review of these guidelines (section I. C. 6) is important for correct code assignment.
Category 338 codes are acceptable as the principal diagnosis (or first-listed code) for reporting purposes in two instances: when the related definitive diagnosis has not been established (confirmed) or when pain control or pain management is the reason for the admission or encounter.
Category 338 should be used in conjunction with site-specific pain codes (including codes from chapter 16) if category 338 codes provide additional information about the pain, such as if it is acute or chronic.
When postoperative pain is not associated with a specific postoperative complication, it is assigned to the appropriate postoperative pain code in category 338. Postoperative pain from a complication (such as a device left in the body) is assigned to the appropriate code (s) found in chapter 17, Injury and Poisoning.
Code 338.3 is used to classify pain related to, associated with, or due to a tumor or cancer whether primary or secondary. This code is used as the principal code when the admission or encounter is for pain control or pain management. In this case, the underlying neoplasm should be reported in addition.
Assign code 338.3, Neoplasm related pain, for a patient that has pain that is related to, associated with, or due to cancer (either primary or secondary) or tumor regardless if the pain is acute or chronic.
According to NCCI, programmable pump analysis with or without reprogramming are components of the pump placement (62361, 62362) and therefore not reported togetherRefilling of the implantable pump can be reported with CPT codes (95990-95991)52
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Pain Management. Coding Information: Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits.
The use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the attached determination.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.