Full Answer
What are the ICD-9 coding guidelines for pain management?
AHA Coding Clinic for ICD-9-CM , 2007, fourth quarter, pages 158-162 13 Coding Guidelines Pain – Category 338 Do not assign a code from subcategories 338.1 and 338.2 if the underlying (definitive) diagnosis is known, unless the reason for the encounter is pain control/management and not management of the underlying condition.
What is the code for admission to hospital for pain management?
•If the reason for admission is for pain control/management, then the code from category 338 is sequenced as principal diagnosis or first-listed code followed by the site-specific pain code.
When do you code postoperative pain as a secondary diagnosis?
•Sequence the postoperative pain code as a secondary diagnosis when the patient develops “unusual or inordinate amount of postoperative pain” after outpatient surgery AHA Coding Clinic for ICD-9-CM , 2007, fourth quarter, pages 158-162 24
What is the CPT code for neoplasm related pain?
•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. •Code 338.3 includes: •Cancer associated pain
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Article Guidance
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.
ICD-10-CM Codes that Support Medical Necessity
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.
Bill Type Codes
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.
Revenue Codes
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.
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