What is the icd 10 code for chronic pain

Review

[F45.41: chronic pain disorder with somatic and psychological factors : a coding aid]

[Article in German]

P Nilges et al. Schmerz. 2010 Jun.

Abstract

In 2009, the German version of ICD-10 (ICD-10 GM version 2009) introduced the diagnosis of "chronic pain disorder with somatic and psychological factors", because current ICD-10 diagnoses did not address the biopsychosocial character of chronic pain adequately. For most patients, a dichotomous classification into psychologically versus biomedically caused pain is inappropriate and does not reflect current knowledge on pain. The new code F45.41 addresses the relevance of psychological factors for chronic pain persistence and chronic pain treatment, even in those conditions with a clear biomedical cause at the beginning. This guideline describes how to use this new diagnosis, which boundaries have to be considered, and how comorbid and associated conditions can be classified. The distinction of this new diagnosis from other pain-associated diagnoses and recommendations for the coding of comorbid conditions are presented. The differentiation of everyday pain symptoms from pain disorders is outlined. Finally, contextual factors of the classification process, as well as problems in integrating this new diagnosis into diagnosis-related group (DRG) systems of financial reimbursement are discussed.

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Coding Chronic Pain and Chronic Pain Syndrome

Published on 

Tuesday, January 31, 2017

Q:

Do the same guidelines in ICD-10-CM apply to chronic pain and chronic pain syndrome as they did in ICD-9? In ICD-9 coders were instructed not to code chronic pain (338.29) if a definitive diagnosis was documented but chronic pain syndrome (338.4) could be reported with a definitive diagnosis.

A:

No, the guidelines in ICD-10 are different than that in ICD-9.

Section I.C.6.a.1 of the (ICD-9) Official Coding Guidelines state “A code from subcategories 338.1 and 338.2 should not be assigned if the underlying (definitive) diagnosis is known, unless the reason for the encounter is pain control/management and not management of the underlying condition.

As you can see the code 338.4 was not included in with that particular guideline so it was therefore assumed that it could be assigned with a documented definitive diagnosis.

The codes in ICD-10 are chronic pain G89.29 and chronic pain syndrome (G89.4).

Section I.C.6.b.1 of the (ICD-10-CM) Official Coding Guidelines state “A code from category G89 should not be assigned if the underlying (definitive) diagnosis is known, unless the reason for the encounter is pain control/management and not management of the underlying condition.

Given that both conditions begin with the category G89, the guideline would include both diagnoses and chronic pain syndrome should not be reported when there is a known definitive diagnosis documented.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.

Chapter 6 - Diseases of the nervous system (G00-G99) » Other disorders of the nervous system (G89-G99) » Chronic pain syndrome (G89.4)

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What is the ICD

ICD-10 code R52 for Pain, unspecified is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .

What is the ICD

NOTE: To utilize these chronic pain diagnosis codes, the exact nature of pain should be specifically documented in the patient medical records; such as “chronic” to utilize ICD-10 code G. 89.29 or the diagnosis term “chronic pain syndrome” to utilize ICD-10 code G89. 4.

What is the ICD

R52 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2023 edition of ICD-10-CM R52 became effective on October 1, 2022. This is the American ICD-10-CM version of R52 - other international versions of ICD-10 R52 may differ.

What is the ICD 9 code for chronic pain?

338.4 Chronic pain syndrome - ICD-9-CM Vol. 1 Diagnostic Codes.