Possible ICD-10 Diagnosis Codes for Chronic Pain Procedures

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1 Possible ICD-10 Diagnosis Codes for Chronic Pain Procedures This document and the information contained herein is for general information purposes only and is not intended and does not constitute legal, reimbursement, coding, business or other advice. Furthermore, it is not intended to increase or maximize payment by any payer. Nothing in this document should be construed as a guarantee by St. Jude Medical regarding levels of reimbursement, payment or charge, or that reimbursement or other payment will be received. Similarly, nothing in this document should be viewed as instructions for selecting any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and claims submitted to thirdparty payers. Also note that the information presented herein represents only one of many potential scenarios, based on the assumptions, variables and data presented. In addition, the customer should note that laws, regulations, coverage and coding policies are complex and updated frequently. Therefore, the customer should check with their local carriers or intermediaries often and should consult with legal counsel or a financial, coding or reimbursement specialist for any coding, reimbursement or billing questions or related issues. This information is for reference purposes only. It is not provided or authorized for marketing use. Possible Chronic Pain Primary Diagnosis Codes G89.21 Chronic pain due to trauma G89.28 Other chronic postprocedural pain G89.29 Other chronic pain G89.4 Chronic pain syndrome 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 or the diagnosis term chronic pain syndrome to utilize ICD-10 code G89.4. If not documented, other symptom diagnosis codes may be utilized. Possible Chronic Pain Secondary Diagnosis Codes B02.22 Postherpetic trigeminal neuralgia B02.29 Other postherpetic nervous system involvement G03.9 Meningitis, unspecified G Complex regional pain syndrome I of right upper limb G Complex regional pain syndrome I of left upper limb G Complex regional pain syndrome I of upper limb, bilateral G Complex regional pain syndrome I of right lower limb G Complex regional pain syndrome I of left lower limb G Complex regional pain syndrome I of lower limb, bilateral G Complex regional pain syndrome I of unspecified lower limb G90.59 Complex regional pain syndrome I of other specified site G89.0 Central pain syndrome G96.12 Meningeal adhesions, spinal, cerebral G54.0 Brachial plexus disorders

2 Possible Chronic Pain Secondary Diagnosis Codes G54.1 Lumbosacral plexus disorders G54.6 Phantom Limb Syndrome; with pain G54.8 Other nerve root and plexus disorders G54.4 Lumbosacral root disorders, not elsewhere classified G56.40 Causalgia of upper limb, unspecified G56.41 Causalgia of right upper limb G56.42 Causalgia of left upper limb G56.80 Other specified mononeuropathies of unspecified upper limb G56.90 Unspecified mononeuropathies of unspecified upper limb G56.91 Unspecified mononeuropathies of right upper limb G56.92 Unspecified mononeuropathies of left upper limb G57.70 Causalgia of lower limb, unspecified G57.71 Causalgia of right lower limb G57.72 Causalgia of left lower limb G57.91 Unspecified mononeuropathies of right lower limb G57.92 Unspecified mononeuropathies of left lower limb I Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity M51.16 Intervertebral disc disorders with radiculopathy, lumbar region M51.17 Intervertebral disc disorders with radiculopathy, lumbosacral region M96.1 Postlaminectomy syndrome, not elsewhere classified M54.12 Radiculopathy, cervical region M54.13 Radiculopathy, cervicothoracic region M54.14 Radiculopathy, thoracic region M54.15 Radiculopathy, thoracolumbar region M54.16 Radiculopathy, lumbar region M54.17 Radiculopathy, lumbosacral region Note: Chronic Pain Secondary Diagnosis Codes should not be sequenced as primary diagnosis codes in ICD-10. In these circumstances, the underlying condition would be typically used as the principal diagnosis.

3 Attention to Device Z45.42 Encounter for adjustment and management of neuropacemaker (brain) (peripheral nerve) (spinal cord) Note: ICD-10 code Z45.42 may be used as a primary diagnosis when the patient is seen for a routine device maintenance, such as perdioc device checks and programming, as well as rough device replacement. A secondary ICD-10 diagnosiscode is typicalls used to identify the underlying condition. Routine sequencing guidelines apply. Encounters Description of final digits (A, D, S) for ICD-10 coding. A: Initial encounter D: Subsequent encounter S: Sequela A: Initial encounters or the patient is receiving active treatment for the injury Surgical treatment Emergency department encounter Evaluation and treatment by a new physician S: Sequela, is used for complications or conditions that arise as a direct result of an injury or an illness, such as chronic pain after an injury. The chronic pain is a sequela of the injury. The chronic pain is reported and sequenced first followed by the appropriate code describing the initial illness or injury with S as the final digit. Example: G89.4 (Chronic pain syndrome) + S24.2XXS (Injury of nerve root of thoracic spine, sequela encounter) D: Subsequent encounter or routine care for the injury during the healing or recovery phase Removal of external of internal fixation device Medication adjustment Aftercare and follow-up visits following injury treatment Encounters S14.101? S14.102? S14.103? S14.104? S14.131? S14.132? S14.133? S14.134? S14.121? S14.122? S14.123? S14.124? S14.151? S14.152? S14.153? S14.154? S14.105? S14.106? S14.107? S14.115? S14.116? S14.117? S14.135? Unspecified injury at C1 level of cervical spinal cord,? encounter Unspecified injury at C2 level of cervical spinal cord,? encounter Unspecified injury at C3 level of cervical spinal cord,? encounter Unspecified injury at C4 level of cervical spinal cord,? encounter Anterior cord syndrome at C1 level of cervical spinal cord,? encounter Anterior cord syndrome at C2 level of cervical spinal cord,? encounter Anterior cord syndrome at C3 level of cervical spinal cord,? encounter Anterior cord syndrome at C4 level of cervical spinal cord,? encounter Central cord syndrome at C1 level of cervical spinal cord,? encounter Central cord syndrome at C2 level of cervical spinal cord,? encounter Central cord syndrome at C3 level of cervical spinal cord,? encounter Central cord syndrome at C4 level of cervical spinal cord,? encounter Other incomplete lesion at C1 level of cervical spinal cord,? encounter Other incomplete lesion at C2 level of cervical spinal cord,? encounter Other incomplete lesion at C3 level of cervical spinal cord,? encounter Other incomplete lesion at C4 level of cervical spinal cord,? encounter Unspecified injury at C5 level of cervical spinal cord,? encounter Unspecified injury at C6 level of cervical spinal cord,? encounter Unspecified injury at C7 level of cervical spinal cord,? encounter Complete lesion at C5 level of cervical spinal cord,? encounter Complete lesion at C6 level of cervical spinal cord,? encounter Complete lesion at C7 level of cervical spinal cord,? encounter Anterior cord syndrome at C5 level of cervical spinal cord,? encounter

4 Encounters S14.136? Anterior cord syndrome at C6 level of cervical spinal cord,? encounter S14.137? Anterior cord syndrome at C7 level of cervical spinal cord,? encounter S14.125? Central cord syndrome at C5 level of cervical spinal cord,? encounter S14.126? Central cord syndrome at C6 level of cervical spinal cord,? encounter S14.127? Central cord syndrome at C7 level of cervical spinal cord,? encounter S14.155? Other incomplete lesion at C5 level of cervical spinal cord,? encounter S14.156? Other incomplete lesion at C6 level of cervical spinal cord,? encounter S14.157? Other incomplete lesion at C7 level of cervical spinal cord,? encounter S14.108? Unspecified injury at C8 level of cervical spinal cord,? encounter S14.118? Complete lesion at C8 level of cervical spinal cord,? encounter S14.128? Central cord syndrome at C8 level of cervical spinal cord,? encounter S14.138? Anterior cord syndrome at C8 level of cervical spinal cord,? encounter S14.158? Other in complete lesion at C8 level of cervical spinal cord,? encounter S24.101? Unspecified injury at T1 level of thoracic spinal cord,? encounter S24.102? Unspecified injury at T2-T6 level of thoracic spinal cord,? encounter S24.111? Complete lesion at T1 level of thoracic spinal cord,? encounter S24.112? Complete lesion at T2-T6 level of thoracic spinal cord,? encounter S24.131? Anterior cord syndrome at T1 level of thoracic spinal cord,? encounter S24.132? Anterior cord syndrome at T2-T6 level of thoracic spinal cord,? encounter S24.151? Other incomplete lesion at T1 level of thoracic spinal cord,? encounter S24.152? Other incomplete lesion at T2-T6 level of thoracic spinal cord,? encounter S24.103? S24.103? Unspecified injury at T7-T10 level of thoracic spinal cord,? encounter S24.104? Unspecified injury at T11-T12 level of thoracic spinal cord,? encounter S24.113? Complete lesion at T7-T10 level of thoracic spinal cord,? encounter S24.114? Complete lesion at T11-T12 level of thoracic spinal cord,? encounter S24.133? Anterior cord syndrome at T7-T10 level of thoracic spinal cord,? encounter S24.134? Anterior cord syndrome at T11-T12 level of thoracic spinal cord,? encounter S24.153? Other incomplete lesion at T7-T10 level of thoracic spinal cord,? encounter S24.154? Other incomplete lesion at T11-T12 level of thoracic spinal cord,? encounter S34.3XX? Injury of cauda equina,? encounter S34.139? Unspecified injury to sacral spinal cord,? encounter S14.109? Unspecified injury at unspecified level of cervical spinal cord,? encounter S24.2XX? Injury of nerve root of thoracic spine,? encounter S34.21X? Injury of nerve root of lumbar spine,? encounter S34.22X? Injury of nerve root of sacral spine,? encounter S14.3XX? Injury of brachial plexus,? encounter S14.2XX? Injury of lumbosacral plexus,? encounter S14.2XX? Injury of nerve root of cervical spine,? encounter S24.2XX? Injury of nerve root of thoracic spine,? encounter S34.21X? Injury of nerve root of lumbar spine,? encounter S34.22X? Injury of nerve root of sacral spine,? encounter

5 1. Centers for Disease Control and Prevention, National Center for Health Statistics, International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) http// Rx Only Brief Summary: Prior to using these devices, please review the Instructions for Use for a complete listing of indications, contraindications, warnings, precautions, potential adverse events and directions for use. Unless otherwise noted, indicates that the name is a trademark of, or licensed to, St. Jude Medical or one of its subsidiaries. ST. JUDE MEDICAL and the nine-squares symbol are trademarks and service marks of St. Jude Medical, Inc. and its related companies St. Jude Medical, Inc. All Rights Reserved. St. Jude Medical Inc. Global Headquarters One St. Jude Medical Drive St. Paul, MN USA T F St. Jude Medical S.C., Inc. Americas Division 6300 Bee Cave Road Bldg. Two, Suite 100 Austin, TX USA T F SJM Coordination Center BVBA The Corporate Village Da Vincilaan 11-Box F1 B-1935 Zaventem, Belgium T F St. Jude Medical Brasil Ltda. Rua Itapeva, 538 5º ao 8º andares São Paulo SP Brazil T F St. Jude Medical (Hong Kong) Ltd. Suite 1608, 16/F Exchange Tower 33 Wang Chiu Road Kowloon Bay, Kowloon Hong Kong SAR T F St. Jude Medical Japan Co., Ltd. Shiodome City Center 15F Higashi Shinbashi, Minato-ku Tokyo Japan T F St. Jude Medical Australia Pty, Ltd. 17 Orion Road Lane Cove, NSW 2066 Australia T F SJMprofessional.com SJM-HER This document is for U.S. use only.

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