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Be sure your coding complies with ICD-9 official guidelines for pain management.
If you don’t know when to check ICD-9 official guidelines, you may have just a 50-50 chance of choosing the proper order for your diagnosis codes.
Case in point: Patients may present to the office for treatment related to pain caused by a neoplasm. In such cases, you will need to determine, which diagnosis codes to report, and you will need to decide what order to list the codes in on your claim. With that in mind, consider how you should code the scenario below.
Start by Examining the Neoplasm-Related Pain Case
Read the following scenario and determine proper ICD-9 coding based on the information given. You’ll find a helpful hint on which section of the official guidelines to review if you get stuck.
Scenario: The physician documents that a patient with lung cancer (middle lobe, primary malignant neoplasm) presented to the office for the purpose of pain management. The pain is documented as acute and caused by the neoplasm.
Hint: See section I.C.6.a.5 of the Official Guidelines for instructions on properly coding these sorts of encounters. The CDC posts ICD-9 guidelines online at: www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm
Next, Determine Which Neoplasm and Pain Codes Apply
For this scenario, before you can decide what order to put the codes in, you will need to decide which codes to report.
Neoplasm: For a primary malignant neoplasm of the lung’s middle lobe, you should report 162.4 (Malignant neoplasm of middle lobe bronchus or lung), says Denae M. Merrill, CPC, HCC coding specialist in Michigan.
Pain: To choose the proper pain diagnosis code, you want to be sure you keep in mind that the neoplasm is the cause. The ICD-9 index entry for pain has several subentries to consider:
...
If you don’t know when to check ICD-9 official guidelines, you may have just a 50-50 chance of choosing the proper order for your diagnosis codes. Patients may present to the office for treatment related to pain caused by a neoplasm. In such cases, you will need to determine which diagnosis codes to report and you will need to decide what order to list the codes in on your claim. With that in mind, consider how you should code the scenario below.
Start by Examining the Neoplasm-Related Pain Case
Read the following scenario and determine proper ICD-9 coding based on the information given. You’ll find a helpful hint on which section of the official guidelines to review if you get stuck.
Scenario: The physician documents that a patient with lung cancer (middle lobe, primary malignant neoplasm) was presented to the office for the purpose of pain management. The pain is documented as acute and caused by the neoplasm.
Hint: See section I.C.6.a.5 of the Official Guidelines for instructions on properly coding these sorts of encounters. The CDC posts ICD-9 guidelines online at: http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm
Next, Determine Which Neoplasm and Pain Codes Apply
For this scenario, before you can decide what order to put the codes in, you will need to decide which codes to report.
Neoplasm: For a primary malignant neoplasm of the lung’s middle lobe, you should report 162.4 (Malignant neoplasm of middle lobe bronchus or lung), says Denae M. Merrill, CPC, HCC coding specialist in Michigan.
Pain: To choose the proper pain diagnosis code, you want to be sure you keep in mind that the neoplasm is the cause. The ICD-9 index entry for pain has several subentries to consider:
...
ICD-9 2011 and ICD-10 2011 both have coding options for a malignant neoplasm of the main bronchus. Both indicate that the codes are appropriate for malignant neoplasms of the carina or hilus of lung. What’s different: ICD-9 2011 includes simply 162.2...
Wrap your brain around using letters in your diagnosis codes.
If you aren’t curious about how the ICD-9 codes crosswalk to ICD-10, maybe you should be.
“The transition date for ICD-10 codes is Oct 1, 2013,” stressed CMS’s Stewart Streimer...