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ICD-9 Nervous System
Coding rules for Section I Chapter 6 of the ICD-9-CM Coding Guidelines
| Question | Answer |
|---|---|
| True/FalseCode in the Pain category 338 may be used in conjunction with codes from other categories and chapters. | True - they can provide more detail about acute or chronic pain and neoplasm-related pain. |
| True/FalseIf pain is not specified as acute or chronic, do not assign a code from category 338. | True - except for post-thoracotomy pain, postoperative pain, neoplasm related pain, or central pain syndrome. |
| True/FalseA code from subcategories 338.1 and 338.2 should be assigned even if the underlying diagnosis is know. | False - A code from subcateogries 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 hte underlying condition |
| True/FalseCategory 338 Pain codes are acceptable as principal diagnosis or first listed code when pain control/management is the reason for the encounter. | True - the underlying cause of the pain should be reported as an additional diagnosis if known |
| True/FalseCategory 338 Pain codes are acceptable as principal diagnosis or first listed codes when an admission or encounter is for a procedure aimed at treating the underlying condition. | False - if the admission is for a procedure aimed at treating the underlying condition, a code for the underlying condition should be assigned as the pdx/first listed dx, and no code from category 338 should be assigned. |
| True/False.Category 338 pain codes are acceptable as principal diagnosis/first listed codes when a patient is admitted for the insertion of a neurostimulator for pain control. | True - assign the appropriate pain code as theprincipa or first listed diagnosis. |
| True/False Category 338 Pain codes are appropriate to use as principal/first listed codes when an admission is for a procedure aimed at treating the underlying condition and a neurostimulator is inserted for pain control during the same encounter | False - when the encounter is for a procedure aimed at treating the underlying condition and a neurostimulator is inserted for pain control during the same period, code the underlying condition as PDX and the appropriate pain code as a secondary dx |
| True/FalseCodes from pain category 338 may be used in conjunction with codes that identify the site pain (including those from chapter 16) if the 338 code provides added info | True - for example, if the code describes the stie of the pain, but does not fully describe whether the pain is acte or chronic, then both codes should be assigned. |
| T/FIf the patient encounter is for pain control or pain management, assign the code from category 338 followed by the code identifying the specific site of pain. | True - for example, encounter for pain management for acute neck pain from trauma is assigned code 338.11, Acute pain due to trauma, followed by code 723.1, Cervicalgia, to identify the site of pain) |
| T/FIf the encounter is for any other reason except pain control or pain management and a related definitive dx has no been established by the provider, assign a code for the specific pain site only | False - in this case you will assign a code for the specific pain site first, but you will follow that by the appropriate code from category 338 |
| T/FRoutine or expected postoperative pain immediately after surgery should not be coded | True |
| T/FPostop pain not associated with specific postop complications is assigned to the appropriate postop pain code in category 338 | True |
| T/FPostop pain associated with specific postop complications is assigned to the appropriate code foundin Chapter 17, Injury and Poisoning | True - if appropriate, use additional codes from category 338 to identify acute or chornic pain 338.18 or 338.28 |
| T/FIf a patient is admitted for pain control/management for postop pain associated with a specific postop condition, then the 338 category code should be assigned as the PDX | True - this follows the same rules from the official coding guidelines Seciton I.C.6.a.1.a |
| T/FPostop pain may be reported as the principal or first listed dx when the stated reason for the admission/encounter is documented as postop pain control/management | True |
| T/FPostop pain may be reported as a secondary dx when a patient presents for outpatient surgery and develops an unusual or inordinate amount of postop pain. | True - the provider's documentation should be used to guide the coding of postop pain as wel las Section III and Setion IV of the coding guidelines |
| T/FChronic pain is classified to subcategory 338.2 with no time frame defining when pain becomes chronic | True - the provider's documentation should be used to guide use of these codes. |
| T/FCode 338.3 (pain related to or associated with cancer) is assigned regardless of whether the pain is acute or chornic | True - this code may be assigned as the principalor first-listed code when the stated reason for the admission/encounter is documented as pain control/pain managment. The underlying neoplasm should be a secondary dx. |
| T/FThe condition "Chronic pain syndrome" is different then the term "chronic pain", and should only be used when the provider has specifically documented this condition | True. |
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