Careful Coding: Headaches

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Careful Coding: Headaches"

Transcription

1 Dynamic Chiropractic March 26, 2012, Vol. 30, Issue 07 Careful Coding: Headaches By K. Jeffrey Miller, DC, DABCO and Ray Tuck, DC Because s are among the most common reasons for seeking chiropractic care, it is important that doctors of chiropractic be well-versed in the ICD-9-CM codes for s. The ICD-9-CM system contains a wide range of codes for s. The codes range from unspecific, listing as a symptom (cephalgia 784.0) to very specific, listing the etiology or condition causing the (349.0 lumbar puncture ). The unspecific nature of some codes is usually a criticism of the ICD-9-CM system. However, it may actually be an advantage when it comes to the diagnosis of head pain, as s can be difficult to diagnose. Headache is not truly a condition, but a symptom. There are no specific orthopedic or neurological physical tests for. There are no lab tests or scans for. Diagnostic modalities do exist for many conditions that cause, but the number of conditions is so great it would not be practical to perform the variety of procedures necessary for differential diagnosis. In light of this, a good case history has proven to be the best method of diagnosis for most s. Headaches are clinical diagnoses. Thus, there are times when the simple diagnosis of cephalgia is the best diagnosis the clinician can assign. The most accurate diagnosis isn t always at hand. This may change with release of the ICD-10 system in the coming months, but for now, everyone must work within the system as it currently exists

2 Using the general code does simplify coding for s. The code can represent general head pain, general vascular head pain or facial pain. Some doctors choose to use this code routinely for most mild to moderate s and the unspecific migraine code for more severe s. Simplification here is not necessarily a bad thing, as long as it is not intentionally misleading. Doctors may also choose to be as specific as possible, especially with migraine s. Efforts can be made to differentiate the type of migraine. Specific coding for two in particular can be important: classical migraine with aura, 346.0, and common migraine without aura, These are reasonably easy to differentiate with an accurate history, making them easy to code. The unspecified code is best used when what seems to be a migraine does not match any of the specific forms of migraines that have codes. Efforts to be more specific are good, but they must follow preparation and study of the available codes. Take for example the condition cervicocranial syndrome 723.2; doctors often assign this diagnosis to patients with cervicogenic s. Cervicocranial syndrome and cervicogenic sound similar. Both have terms associated with the neck and head, but they are not equivalent. Cervicocranial syndrome, also known as posterior cervical sympathetic syndrome and Barre -Lieou syndrome, presents with suboccipital pain, vertigo, intermittent hoarseness, severe fatigue and in some cases, aching along one side of the face and eye. Suggested etiologies include occlusion of the vertebral arteries, involvement of the cervical sympathetic system and interference with neck reflexes. 1 Symptoms can sometimes be reproduced in these patients with head rotation (Barre -Lieou sign)

3 This condition differs greatly from cervicogenic. The International Headache Society s criteria for s related to the cervical spine describes pain in the occipital region, temples, forehead, orbital region, ears or vertex associated with abnormal neck movement and/or posture. Pain could be originating from pain-sensitive structures in the cervical spine; the facet or condylar joints, the periosteum of bone, spinal ligaments and other structures. 3 A doctor of chiropractic identifying cervicocranial syndrome will likely be obtaining a consult for their patient, if not a complete referral. A doctor of chiropractic identifying cervicogenic s will be the most qualified practitioner to address the condition. Accuracy is always important, but it is especially vital in this situation. Cervicocranial syndrome associated with vertebral artery complications is an obvious concern. Accuracy is also vital when coding tension s, as there are two types. Many use the code This is the code for tension s listed under mental disorders in the ICD-9-CM system, specifically "Pain disorders related to psychological factors." The correct codes for tension s that fall within the chiropractic scope of practice are through This group of codes is listed under "Nervous system and sense organ disorders" in the ICD-9-CM system. Like migraines and tension s, temporomandibular joint (TMJ) disorders/dysfunctions have several coding choices. The codes range from to Since the cephalgia code can be used for facial pain, it is another possible TMJ code. The descriptions for the to codes are clear and easy to use compared to some of the other codes. It should be mentioned that in the case of temporomandibular joint disorders, physical examination has a greater utility than it does with most other causes of. Many of the dysfunctions are observable or detectable objectively. This augments the utility of the case history. The types of s discussed to this point cover the majority of encountered routinely in a chiropractic practice. However, two other types need to be mentioned: post-traumatic and lumbar puncture s. Post-traumatic s, acute and chronic, are common following motor-vehicle accidents, sports injuries and falls. The key here is differentiating the acute form, 339.2,1 from the chronic form, The difference is related to the amount of time symptoms have been present; six weeks or less and more than six - 3 -

4 weeks, respectively. Lumbar puncture is a coding concern for the chiropractic practitioner. The etiology of this is leak of cerebrospinal fluid from the injection site after an epidural injection or the injection site from a myelogram. This can be extremely painful. It is very distressing to experience or observe. If the occurs, it usually develops within the first 48 hours after the procedure. It is amazing how often medical personnel fail to describe the possibility of this side effect to patients and how quick they are to blame its occurrence on chiropractic care received soon after the injection. It is the authors recommendation that chiropractic care be delayed for at least 48 hours after spinal injections of this nature. Delaying care is safe for the patient and chiropractor allowing time for the to occur and be addressed by those who caused it. As stated, the s and related codes discussed above are common in chiropractic practice. Table 1 depicts the s, codes and their descriptions. Familiarity with the codes from Table 1 is important. Additionally, doctors should look for the upcoming ICD-10-CM coding manual, due to take effect in Comparison of the current and new codes will be necessary to ensure accuracy in coding of s and other conditions. Table 1: Recommended ICD-9-CM Codes for Head and Face Pain in Chiropractic Care Condition / Diagnosis ICD-9-CM Code Comments Headache This is a symptom code. It is nonspecific. This code can also be used for a nonspecific vascular head pain and facial pain; in other words, a nonspecific migraine or TMJ. This code is applicable to sinus head pain Temporomandibular joint (TMJ), unspecified TMJ adhesions and ankylosis General dysfunction This would be for a chronic condition Arthralgia of TMJ General pain Articular disc disorder Crepitus, aberrant motion - 4 -

5 TMJ sounds on opening and closing jaw Other specified TMJ disorders Joint crepitus Etiology can vary Migraine with aura The code for classical migraines that are preceded by a neurological sign or symptom Migraine without aura The code for common migraines Migraine, unspecified The least specific code for migraine s Tension, unspecified Episodic tension-type Chronic tension type Post-traumatic, unspecified Acute post-traumatic Chronic post-traumatic General, hatband distribution Occasional, hatband distribution Daily, hatband distribution Associated with whiplash and similar conditions Associated with whiplash and similar conditions Associated with whiplash and similar conditions Lumbar puncture Headache following lumbar puncture Adapted from International Classification of Diseases, 9th Revision, Clinical Modification, 6th Edition, 2011 Office Edition, Volumes 1 &2. Practice Management Information Corporation (PMIC), Los Angeles, References 1. Murphy DR. Conservative Management of Cervical Spine Syndromes. McGraw-Hill, Cipriano JJ. Photographic Manual of Regional Orthopaedic and Neurological Tests. Wolters Kluwer / Lippincott Williams & Wilkins, Philadelphia, PA, Jay GW. The Headache Handbook: Diagnosis and Treatment. CRC Press, Boca Raton, FL,

6 As mentioned, the ICD-10 is scheduled for release in 2013 and contains substantially more codes than the ICD-9. Providers should make sure they are current on any and all code changes when the new version is released for use. Click here for more information about K. Jeffrey Miller, DC, DABCO. Dr. Ray Tuck s leadership and vision have been responsible for developing Tuck Chiropractic Clinics into one of the largest most successful group of clinics in the eastern United States. Page printed from:

Differential Diagnosis of Craniofacial Pain

Differential Diagnosis of Craniofacial Pain 1. Differential Diagnosis of Craniofacial Pain 2. Headache Page - 1 3. International Headache Society International Classification... 4. The Primary Headaches (1-4) Page - 2 5. The Secondary Headaches

More information

Whiplash and Whiplash- Associated Disorders

Whiplash and Whiplash- Associated Disorders Whiplash and Whiplash- Associated Disorders North American Spine Society Public Education Series What Is Whiplash? The term whiplash might be confusing because it describes both a mechanism of injury and

More information

Clinical guidance for MRI referral

Clinical guidance for MRI referral MRI for cervical radiculopathy Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of spine for a patient 16 years or older for suspected: cervical radiculopathy

More information

Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario

Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Page 1 Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Injury Descriptions Developed from Newfoundland claim study injury definitions No injury Death Psychological

More information

On Cervical Zygapophysial Joint Pain After Whiplash. Spine December 1, 2011; Volume 36, Number 25S, pp S194 S199

On Cervical Zygapophysial Joint Pain After Whiplash. Spine December 1, 2011; Volume 36, Number 25S, pp S194 S199 On Cervical Zygapophysial Joint Pain After Whiplash 1 Spine December 1, 2011; Volume 36, Number 25S, pp S194 S199 Nikolai Bogduk, MD, PhD FROM ABSTRACT Objective To summarize the evidence that implicates

More information

*A discrete, hypersensitive nodule within tight band of muscle or fascia that present with classic pattern of pain referral that does not follow

*A discrete, hypersensitive nodule within tight band of muscle or fascia that present with classic pattern of pain referral that does not follow A patient presents with c/o cervical spine pain and chronic headaches that radiates across the top of his head. He also experiences frequent bouts of nausea, dizziness and indigestion. The patient also

More information

ICD-10 for the Chiropractic Procrastinator

ICD-10 for the Chiropractic Procrastinator ICD-10 for the Chiropractic Procrastinator Presented By Chiropractic Care of Minnesota, Inc. (CCMI) Authored By Dr. Evan Gwilliam, DC, MBA, BS, CPC, CCPC, NCICS, CCCPC, CPC-I, CPMA, MCS-P Introduction

More information

A chiropractic approach to managing migraine

A chiropractic approach to managing migraine A chiropractic approach to managing migraine What is chiropractic? Chiropractic is a primary healthcare profession that specialises in the diagnosis, treatment and overall management of conditions that

More information

Pathoanatomical Changes of the Brachial Plexus and of C5-C6 Following Whiplash-Type Injury: A Case Report

Pathoanatomical Changes of the Brachial Plexus and of C5-C6 Following Whiplash-Type Injury: A Case Report Pathoanatomical Changes of the Brachial Plexus and of C5-C6 Following Whiplash-Type Injury: A Case Report 1 Journal Of Whiplash & Related Disorders Vol. 1, No, 1, 2002 Gunilla Bring, Halldor Jonsson Jr.,

More information

CHIROPRACTIC WELLNESS AWARENESS ONE FREE MASSAGE SESSION

CHIROPRACTIC WELLNESS AWARENESS ONE FREE MASSAGE SESSION CHIROPRACTIC WELLNESS AWARENESS Do you want to have a healthy body? Do you like to maintain your high energy level? Do you want to be stress-less? Do you like to be pain free? Please call Conrad Nieh D.C.

More information

Colossus Important Diagnoses. Instructions for How to List Diagnoses

Colossus Important Diagnoses. Instructions for How to List Diagnoses 1 Colossus Important Diagnoses Instructions for How to List Diagnoses 1. Only list diagnoses on HCFA-1500 or CMS-1500 billing forms 2. Use as many billing forms/pages as necessary (4 diagnoses per billing

More information

Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies

Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies Cervicogenic Headache: A Review of Diagnostic and Treatment Strategies 1 Journal of the American Osteopathic Association April 2005, Vol. 105, No. 4 supplement, pp. 16-22 David M. Biondi, DO FROM ABSTRACT:

More information

The information contained in these notes is for educational purposes and is not intended to be and is not legal advice.

The information contained in these notes is for educational purposes and is not intended to be and is not legal advice. PART 3: ICD-10 Coding of Diseases and Conditions (2 Hours) With Mario Fucinari DC, MCS-P Certified Insurance Consultant Certified Medical Compliance Specialist (MCS-P) Presented by Foot Levelers The information

More information

Headaches + Facial pain

Headaches + Facial pain Headaches + Facial pain Introduction: Each of us experienced sporadically/ chronically headache 40% worldwide population suffers with severe, disabling headache at least annually Common ailment Presenting

More information

Any rapid head movement can cause a Whiplash. ALTERNATIVE CARE CHIROPRACTIC Reston, Virginia

Any rapid head movement can cause a Whiplash. ALTERNATIVE CARE CHIROPRACTIC Reston, Virginia ALTERNATIVE CARE CHIROPRACTIC Reston, Virginia P ROV E N R E L I E F F RO M W H I P L A S H Any rapid head movement can cause a Whiplash injury. Although whiplash is commonly associated with car accidents

More information

Oh, 14 C O M M U N I T Y M A G A Z I N E S M A Y / J U N E 2 0 0 8

Oh, 14 C O M M U N I T Y M A G A Z I N E S M A Y / J U N E 2 0 0 8 14 C O M M U N I T Y M A G A Z I N E S M A Y / J U N E 2 0 0 8 Oh, my aching head NEW DOCTOR TEAM ADDRESSES CHRONIC HEADACHE PROBLEMS SEVERE HEADACHES IN THIS COUNTRY ARE A LEADING CAUSE OF DISRUP- TION

More information

THE LUMBAR SPINE (BACK)

THE LUMBAR SPINE (BACK) THE LUMBAR SPINE (BACK) At a glance Chronic back pain, especially in the area of the lumbar spine (lower back), is a widespread condition. It can be assumed that 75 % of all people have it sometimes or

More information

ICD-10: Supporting you Over the Hurdles

ICD-10: Supporting you Over the Hurdles ICD-10: Supporting you Over the Hurdles Presented by Evan M. Gwilliam DC MBA BS CPC CCPC NCICS CCCPC CPC-I MCS-P CPMA Vice President, ChiroCode 1 Overview ICD-10 fundamentals and navigation Diagnosis coding

More information

SpineFAQs. Whiplash. What causes this condition?

SpineFAQs. Whiplash. What causes this condition? SpineFAQs Whiplash Whiplash is defined as a sudden extension of the cervical spine (backward movement of the neck) and flexion (forward movement of the neck). This type of trauma is also referred to as

More information

WHIPLASH! Therapeutic Massage by Lucy Lucy Dean, LMT, NMT, MMT. Helpful and effective treatment with Neuromuscular Therapy. What does Whiplash mean?

WHIPLASH! Therapeutic Massage by Lucy Lucy Dean, LMT, NMT, MMT. Helpful and effective treatment with Neuromuscular Therapy. What does Whiplash mean? WHIPLASH! Helpful and effective treatment with Neuromuscular Therapy Therapeutic Massage by Lucy Lucy Dean, LMT, NMT, MMT What does Whiplash mean? Whiplash is a non-medical term used to describe neck pain

More information

Change is Coming in 2014! ICD-10 will replace ICD-9 for Diagnosis Coding

Change is Coming in 2014! ICD-10 will replace ICD-9 for Diagnosis Coding Change is Coming in 2014! ICD-10 will replace ICD-9 for Diagnosis Coding Clinical Coding Diagnosis Codes Clinicians select ICD-CM codes to describe a patient s diagnoses, symptoms, and clinical findings.

More information

Whiplash Associated Disorder

Whiplash Associated Disorder Whiplash Associated Disorder Bourassa & Associates Rehabilitation Centre What is Whiplash? Whiplash is a non-medical term used to describe neck pain following hyperflexion or hyperextension of the tissues

More information

Post Traumatic and other Headache Syndromes. Danielle L. Erb, MD Brain Rehabilitation Medicine, LLC Brain Injury Rehab Center, PRA

Post Traumatic and other Headache Syndromes. Danielle L. Erb, MD Brain Rehabilitation Medicine, LLC Brain Injury Rehab Center, PRA Post Traumatic and other Headache Syndromes Danielle L. Erb, MD Brain Rehabilitation Medicine, LLC Brain Injury Rehab Center, PRA Over 45 million Americans have chronic, recurring headaches 62% of these

More information

Whiplash injuries can be visible by functional magnetic resonance imaging. Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp.

Whiplash injuries can be visible by functional magnetic resonance imaging. Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp. Whiplash injuries can be visible by functional magnetic resonance imaging 1 Bengt H Johansson, MD FROM ABSTRACT: Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp. 197-199 Whiplash trauma can

More information

HEADACHES AND THE THIRD OCCIPITAL NERVE

HEADACHES AND THE THIRD OCCIPITAL NERVE HEADACHES AND THE THIRD OCCIPITAL NERVE Edward Babigumira M.D. FAAPMR. Interventional Pain Management, Lincoln. B. Pain Clinic, Ltd. Diplomate ABPMR. Board Certified Pain Medicine No disclosures Disclosure

More information

Standard of Care: Cervical Radiculopathy

Standard of Care: Cervical Radiculopathy Department of Rehabilitation Services Physical Therapy Diagnosis: Cervical radiculopathy, injury to one or more nerve roots, has multiple presentations. Symptoms may include pain in the cervical spine

More information

Chronic whiplash and whiplash-associated disorders: An evidence-based approach

Chronic whiplash and whiplash-associated disorders: An evidence-based approach Chronic whiplash and whiplash-associated disorders: An evidence-based approach 1 Journal of the American Academy of Orthopedic Surgeons October 2007;15(10):596-606 Schofferman J, Bogduk N, Slosar P. FROM

More information

ISPI Newsletter Archive - Whiplash

ISPI Newsletter Archive - Whiplash ISPI Newsletter Archive - Whiplash March 2005 Widespread Sensory Hypersensitivity Is a Feature of Chronic Whiplash - Associated Disorder but not Chronic Idiopathic Neck Pain. Clin J Pain. 2005 Mar-Apr;21

More information

Online Course Descriptions (degree seeking):

Online Course Descriptions (degree seeking): Online Course Descriptions (degree seeking): BSC 6001 Foundations of Clinical Orthopaedics This is an online self study course discussing the foundations of orthopaedics and manipulative therapy. The history

More information

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or 1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual

More information

Headaches!!! What can Physical Therapy do??? Paul Wortley PT Rocky Mountain Therapy Services

Headaches!!! What can Physical Therapy do??? Paul Wortley PT Rocky Mountain Therapy Services Headaches!!! What can Physical Therapy do??? Paul Wortley PT Rocky Mountain Therapy Services Take 2 Aspirin and Call Me in the Morning FACTS During the past year, nearly 90-95% men and women have had a

More information

UTILIZING STRAPPING AND TAPING CODES FOR HEALTH CARE REIMBURSEMENT:

UTILIZING STRAPPING AND TAPING CODES FOR HEALTH CARE REIMBURSEMENT: UTILIZING STRAPPING AND TAPING CODES FOR HEALTH CARE REIMBURSEMENT: A GUIDE TO BILLING FOR SPIDERTECH PRE-CUT APPLICATIONS AND TAPE Billing and coding taping and strapping services can be a complex issue.

More information

Getting Ready for ICD-10. Dianna Hoskins, OCS Cincinnati Eye Institute

Getting Ready for ICD-10. Dianna Hoskins, OCS Cincinnati Eye Institute Dianna Hoskins, OCS Cincinnati Eye Institute Chart Documentation: Will your documentation stand up to ICD-10? Do you always mark which eye, severity or status of the disease (chronic or acute), site, etiology

More information

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL CASE NO. 18 Z 600 01641 03 2 A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS In the Matter of the Arbitration between (Claimant) AAA CASE NO.: 18 Z 600 01641 03 v.

More information

LOW BACK PAIN; MECHANICAL

LOW BACK PAIN; MECHANICAL 1 ORTHO 16 LOW BACK PAIN; MECHANICAL Background This case definition was developed by the Armed Forces Health Surveillance Center (AFHSC) for the purpose of epidemiological surveillance of a condition

More information

Case Studies Updated 10.24.11

Case Studies Updated 10.24.11 S O L U T I O N S Case Studies Updated 10.24.11 Hill DT Solutions Cervical Decompression Case Study cant neck pain, headaches, and bilateral parathesia. The above captioned patient complained of neck pain,

More information

The Chiropractic Profession s Role in Helping to Meet Vermont's Health Care Reform Goals. Better care Better health Lower costs

The Chiropractic Profession s Role in Helping to Meet Vermont's Health Care Reform Goals. Better care Better health Lower costs The Chiropractic Profession s Role in Helping to Meet Vermont's Health Care Reform Goals Better care Better health Lower costs Chiropractic Abstract: Chiropractic is now more than a century old, and it

More information

International Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum

International Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum International Postprofessional Doctoral of Physical Therapy (DPT) in Musculoskeletal Management Program (non US/Canada) Curriculum Effective: July 2015 INTERNATIONAL POSTPROFESSIONAL DOCTORAL OF PHYSICAL

More information

Acknowledgement of Receipt of Notice of Privacy Practices

Acknowledgement of Receipt of Notice of Privacy Practices Acknowledgement of Receipt of Notice of Privacy Practices **You May Refuse to Sign This Acknowledgement** I,, have received a copy of this office s Notice of Privacy Practices. Signature For Office Use

More information

Temple Physical Therapy

Temple Physical Therapy Temple Physical Therapy A General Overview of Common Neck Injuries For current information on Temple Physical Therapy related news and for a healthy and safe return to work, sport and recreation Like Us

More information

Spine University s Guide to Kinetic MRIs Detect Disc Herniations

Spine University s Guide to Kinetic MRIs Detect Disc Herniations Spine University s Guide to Kinetic MRIs Detect Disc Herniations 2 Introduction Traditionally, doctors use a procedure called magnetic resonance imaging (MRI) to diagnose disc injuries. Kinetic magnetic

More information

Headaches. This chapter will discuss:

Headaches. This chapter will discuss: C H A P T E R Headaches 1 1 Almost everyone gets an occasional headache at some time or another. Some people get frequent headaches. Most people do not worry about headaches and learn to live with them

More information

Using the Balance Board in Therapy

Using the Balance Board in Therapy Using the Balance Board in Therapy Practical applications for linking somato-sensory and vestibular systems to the collaboration between the eyes and brain. Vision Therapy establishes and supports visual

More information

Chiropractic ICD-10 Common Codes List

Chiropractic ICD-10 Common Codes List Chiropractic ICD-10 Common Codes List This is a preliminary list of common ICD-10 codes for chiropractic diagnoses. This is a common code list to be used as a guide for coding and is not intended to represent

More information

Symptoms and Signs of Irritation of the Brachial Plexus in Whiplash Injuries

Symptoms and Signs of Irritation of the Brachial Plexus in Whiplash Injuries 1 Symptoms and Signs of Irritation of the Brachial Plexus in Whiplash Injuries J Bone Joint Surg (Br) 2001 Mar;83(2):226-9 Ide M, Ide J, Yamaga M, Takagi K Department of Orthopaedic Surgery, Kumamoto University

More information

Headache: Differential diagnosis and Evaluation. Raymond Rios PGY-1 Pediatrics

Headache: Differential diagnosis and Evaluation. Raymond Rios PGY-1 Pediatrics Headache: Differential diagnosis and Evaluation Raymond Rios PGY-1 Pediatrics You are evaluating a 9 year old male patient at the ED brought by his mother, who says that her son has had a fever, cough,

More information

Whiplash Associated Disorder

Whiplash Associated Disorder Whiplash Associated Disorder The pathology Whiplash is a mechanism of injury, consisting of acceleration-deceleration forces to the neck. Mechanism: Hyperflexion/extension injury Stationary vehicle hit

More information

6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S.

6/3/2011. High Prevalence and Incidence. Low back pain is 5 th most common reason for all physician office visits in the U.S. High Prevalence and Incidence Prevalence 85% of Americans will experience low back pain at some time in their life. Incidence 5% annual Timothy C. Shen, M.D. Physical Medicine and Rehabilitation Sub-specialty

More information

Guidelines for the Practice of Chiropractic in North Carolina

Guidelines for the Practice of Chiropractic in North Carolina Guidelines for the Practice of Chiropractic in North Carolina Introduction "North Carolina is a C.C.E. state." This simple statement encapsulates the wide-ranging influence exerted by the Council on Chiropractic

More information

Dr. Brendan Stack Orthodontist, DDS, MS Washington, DC

Dr. Brendan Stack Orthodontist, DDS, MS Washington, DC Dr. Brendan Stack Orthodontist, DDS, MS Washington, DC Dr. Stack is a University trained orthodontist (Georgetown University) who, since 1965, has limited his practice in Northern Virginia (Washington,

More information

Summary of Recommendations

Summary of Recommendations CHIROPRACTIC CLINICAL PRACTICE GUIDELINE Adult Neck Pain Not Due to Whiplash Summary of Recommendations November 2005 Note: This summary does not replace or supercede the content of the detailed technical

More information

CMS Imaging Efficiency Measures Included in Hospital Outpatient Quality Data Reporting Program (HOP QDRP) 2009

CMS Imaging Efficiency Measures Included in Hospital Outpatient Quality Data Reporting Program (HOP QDRP) 2009 CMS Imaging Efficiency Measures Included in Hospital Outpatient Quality Data Reporting Program (HOP QDRP) 2009 OP 8: MRI LUMBAR SPINE FOR LOW BACK PAIN Measure Description: This measure estimates the percentage

More information

Clinical Reasoning The patient presents with no red flags and no indications of maladaptive behaviour in regard to fear avoidance.

Clinical Reasoning The patient presents with no red flags and no indications of maladaptive behaviour in regard to fear avoidance. The McKenzie Institute International 2014 Vol. 3, No. 3 CASE REVIEW: A CLINICIAN S PERSPECTIVE Case Review: 35-Year-Old Male with History of Low Back Pain Brian Østergaard Sørensen, PT, Dip.MDT Introduction

More information

Post Graduate Studies Chiropractic Mgmt. of Lumbar Disc Derangements Bill Morgan, DC, DAAPM Baltimore, MD March 2015

Post Graduate Studies Chiropractic Mgmt. of Lumbar Disc Derangements Bill Morgan, DC, DAAPM Baltimore, MD March 2015 Dr. Patrick Ingram, D.C. Maryland Spine Care 517 Main Street Reisterstown, MD. 21136 drpatingram@comcast.net www.marylandspinecare.com P- 410.833.3038 F- 410.833.3039 Education Palmer College of Chiropractic

More information

Whiplash and Cervical Spine Disorders: Evaluation and Management

Whiplash and Cervical Spine Disorders: Evaluation and Management Whiplash and Cervical Spine Disorders: Evaluation and Management Dr. Corrie Graboski Definition by Quebec Task Force Pain Generators an acceleration-deceleration mechanism of energy transfer to the neck

More information

Breeze Your Way To ICD - 10. Presented by Fred Melroy

Breeze Your Way To ICD - 10. Presented by Fred Melroy Breeze Your Way To ICD - 10 Presented by Fred Melroy Disclaimer The materials and the information contained in the webinar are provided as is, and CureMD makes no express or implied representations or

More information

33 % of whiplash patients develop. headaches originating from the upper. cervical spine

33 % of whiplash patients develop. headaches originating from the upper. cervical spine 33 % of whiplash patients develop headaches originating from the upper cervical spine - Dr Nikolai Bogduk Spine, 1995 1 Physical Treatments for Headache: A Structured Review Headache: The Journal of Head

More information

CHA SERIES. Key Chiropractic Concepts for the CHA. Ontario Chiropractic Association. Treatment That Stands Up.

CHA SERIES. Key Chiropractic Concepts for the CHA. Ontario Chiropractic Association. Treatment That Stands Up. CHA SERIES Key Chiropractic Concepts for the CHA AGENDA Welcome & Introductions About Chiropractic Terminology ABOUT CHIROPRACTIC You will get lots of questions about the profession & chiropractic care

More information

Osteopathic Manipulative Treatment is a distinct and separate procedure,

Osteopathic Manipulative Treatment is a distinct and separate procedure, The Science of Medicine The Art of Caring The Power of Touch The purpose of this letter is to request reconsideration of your denial of the Evaluation and Management service (with the -25 modifier) when

More information

Seven Myths About Back Pain

Seven Myths About Back Pain Seven Myths About Back Pain As reported in Safety Bulletin BCL004, Lifting and Your Back Some Fresh Ideas, up to 80 per cent of adults will experience back pain at some time during their lives. Let s take

More information

Medical Treatment Guidelines Washington State Department of Labor and Industries

Medical Treatment Guidelines Washington State Department of Labor and Industries Complex regional pain syndrome (CRPS) Formerly known as reflex sympathetic dystrophy 1. Introduction This bulletin outlines the Department of Labor and Industries guidelines for diagnosing and treating

More information

SPA PCP Treatment & Referral Guidelines Pain Management Developed June 1, 2003 Revised - (Format Revisions) November 13, 2006

SPA PCP Treatment & Referral Guidelines Pain Management Developed June 1, 2003 Revised - (Format Revisions) November 13, 2006 SUTTER PHYSICIANS ALLIANCE (SPA) 2800 L Street, 7 th Floor Sacramento, CA 95816 SPA PCP Treatment & Referral Guidelines Pain Management Developed June 1, 2003 Revised - (Format Revisions) November 13,

More information

The Neck: Whiplash & Central Ligament Sprains. Presented by Dr. Ben Benjamin

The Neck: Whiplash & Central Ligament Sprains. Presented by Dr. Ben Benjamin Debilitating Orthopedic Injury Sampler #1 The Neck: Whiplash & Central Ligament Sprains Presented by Dr. Ben Benjamin Instructor: Ben Benjamin, Ph.D. 2 1 Instructor: Ben Benjamin, Ph.D. drben@benbenjamin.com

More information

Facet and Axial Spine Pain

Facet and Axial Spine Pain Facet and Axial Spine Pain Diane M. Rowles, MS, ACNP, BC, CRRN Nurse Practitioner, University Neurosurgery Rush University Medical Center Adjunct Assistant Professor, Feinberg School of Medicine Northwestern

More information

WHIPLASH INJURIES By Prof RP Grabe, Department of Orthopaedics, University of Pretoria

WHIPLASH INJURIES By Prof RP Grabe, Department of Orthopaedics, University of Pretoria 1 WHIPLASH INJURIES By Prof RP Grabe, Department of Orthopaedics, University of Pretoria In a recent publication in Spine the Quebec task force mentions that very little is available in the literature

More information

X-Plain Temporomandibular Joint Disorders Reference Summary

X-Plain Temporomandibular Joint Disorders Reference Summary X-Plain Temporomandibular Joint Disorders Reference Summary Introduction Temporomandibular joint disorders, or TMJ disorders, are a group of medical problems related to the jaw joint. TMJ disorders can

More information

HEADACHE. as. MUDr. Rudolf Černý, CSc. doc. MUDr. Petr Marusič, Ph.D.

HEADACHE. as. MUDr. Rudolf Černý, CSc. doc. MUDr. Petr Marusič, Ph.D. HEADACHE as. MUDr. Rudolf Černý, CSc. doc. MUDr. Petr Marusič, Ph.D. Dpt. of Neurology Charles University in Prague, 2nd Faculty of Medicine Motol University Hospital History of headache 1200 years B.C.

More information

UBC Pain Medicine Residency Program: CanMEDS Goals and Objectives of the UBC Headache Clinic Rotation

UBC Pain Medicine Residency Program: CanMEDS Goals and Objectives of the UBC Headache Clinic Rotation UBC Pain Medicine Residency Program: CanMEDS Goals and Objectives of the UBC Headache Clinic Rotation Overview: The UBC Headache Clinic is located in located in rm. 267, on the 2nd floor of UBC Hospital.

More information

ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015

ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015 Presented by: Teri Romano, RN, MBA, CPC, CMDP ICD 10 CM IMPLEMENTATION DATE OCT 1, 2015 Source: http://journal.ahima.org/2015/02/04/us house committee to hold hearing on icd 10 implementation/ 2 2015 Web_Non

More information

Diagnosis and Management for Chronic Back Pain: Critical for your Recovery

Diagnosis and Management for Chronic Back Pain: Critical for your Recovery Diagnosis and Management for Chronic Back Pain: Critical for your Recovery Dr. Connie D Astolfo, DC, PhD (candidate) In past articles I have stressed that the causes of back pain can be very complex. This

More information

Spine Trauma: When to Transfer. Alexander Ching, MD Director, Orthopaedic Spine Trauma OHSU

Spine Trauma: When to Transfer. Alexander Ching, MD Director, Orthopaedic Spine Trauma OHSU Spine Trauma: When to Transfer Alexander Ching, MD Director, Orthopaedic Spine Trauma OHSU Disclosures Depuy Spine Consultant (teaching and courses) Department education and research funds Atlas Spine

More information

Soft-tissue injuries of the neck in automobile accidents: Factors influencing prognosis

Soft-tissue injuries of the neck in automobile accidents: Factors influencing prognosis Soft-tissue injuries of the neck in automobile accidents: Factors influencing prognosis 1 Mason Hohl, MD FROM ABSTRACT: Journal of Bone and Joint Surgery (American) December 1974;56(8):1675-1682 Five years

More information

The multitude of symptoms following a whiplash injury has given rise to much discussion because of the lack of objective radiological findings.

The multitude of symptoms following a whiplash injury has given rise to much discussion because of the lack of objective radiological findings. HELPFUL PERSONAL INJURY INFORMATION COURTESY OF RIVERVIEW CHIROPRACTIC FROM ABSTRACT: Dynamic kine magnetic resonance imaging in whiplash patients Pain Research and Management 2009 Nov-Dec 2009;Vol. 14,

More information

The Prognosis Of Neck Injuries Resulting From Rear-end Vehicle Collisions. The Journal Of Bone And Joint Surgery (British)

The Prognosis Of Neck Injuries Resulting From Rear-end Vehicle Collisions. The Journal Of Bone And Joint Surgery (British) The Prognosis Of Neck Injuries Resulting From Rear-end Vehicle Collisions 1 S. H. Norris, I. Watt FROM ABSTRACT The Journal Of Bone And Joint Surgery (British) November 1983, Vol. 65-B. No. 5 Injury of

More information

TOP 10 THINGS YOU MUST KNOW BEFORE CHOOSING YOUR ORTHODONTIST I N T R O D U C T O R Y L E T T E R F R O M D R. W H I T E

TOP 10 THINGS YOU MUST KNOW BEFORE CHOOSING YOUR ORTHODONTIST I N T R O D U C T O R Y L E T T E R F R O M D R. W H I T E TOP 10 THINGS YOU MUST KNOW BEFORE CHOOSING YOUR ORTHODONTIST I N T R O D U C T O R Y L E T T E R F R O M D R. W H I T E 0 INTRODUCTORY LETTER FROM DR. WHITE Dear Friend, If you are researching orthodontists

More information

TMJ DISEASE TEMPOROMANDIBULAR JOINT DISEASE

TMJ DISEASE TEMPOROMANDIBULAR JOINT DISEASE TMJ DISEASE TEMPOROMANDIBULAR JOINT DISEASE The temporomandibular joint is the point at which the mandible (lower jaw) hinges on the skull. Frequently, the pain experienced is ear pain, s o patients are

More information

TMJ. Problems. Certain headaches and pain in. the ear, jaw, neck, tooth, and. sinus can be the result of a. temporomandibular joint (TMJ)

TMJ. Problems. Certain headaches and pain in. the ear, jaw, neck, tooth, and. sinus can be the result of a. temporomandibular joint (TMJ) DIVISION OF ORAL AND MAXILLOFACIAL SURGERY TMJ Problems Certain headaches and pain in the ear, jaw, neck, tooth, and sinus can be the result of a temporomandibular joint (TMJ) problem. People with TMJ

More information

Back & Neck Pain Survival Guide

Back & Neck Pain Survival Guide Back & Neck Pain Survival Guide www.kleinpeterpt.com Zachary - 225-658-7751 Baton Rouge - 225-768-7676 Kleinpeter Physical Therapy - Spine Care Program Finally! A Proven Assessment & Treatment Program

More information

Brain Injury July 2010; 24(7 8): 988 994

Brain Injury July 2010; 24(7 8): 988 994 A case-control study of cerebellar tonsillar (Chiari) and head/neck trauma (whiplash) 1 Brain Injury July 2010; 24(7 8): 988 994 Michael D. Freeman, Scott Rosa, David Harshfield, Francis Smith, Robert

More information

Sports. Concussion. Disorder by site:

Sports. Concussion. Disorder by site: Concussion Sports S06.0 Concussion Code also any associated: open wound of head (S01.-) skull fracture (S02.-) Excludes1: head injury NOS (S09.90) The appropriate 7th character is to be added to each code

More information

Optum Physical Health. Clinical Forms Instruction Manual

Optum Physical Health. Clinical Forms Instruction Manual Optum Physical Health Clinical Forms Instruction Manual OptumHealth Care Solutions Physical Health includes OptumHealth Care Solutions, Inc., ACN Group IPA of New York, Inc., Managed Physical Network,

More information

ICD10 Chiropractic Diagnosis Codes

ICD10 Chiropractic Diagnosis Codes ICD10 Chiropractic Diagnosis Codes Disclaimer: When the ICD-10 code requires a 7th character, the code shown assumes "initial." Disclaimer: This information is based on the General Equivalency Mapping

More information

Joshua A. Cleland, PT, DPT, PhD, OCS, FAAOMPT

Joshua A. Cleland, PT, DPT, PhD, OCS, FAAOMPT Joshua A. Cleland, PT, DPT, PhD, OCS, FAAOMPT Franklin Pierce University Presentations at Scientific Meetings: Changes in Pain and Cervical Range of Motion after Cervical or Thoracic Thrust Manuscript

More information

STRESS. Health & Wellness The Newsletter About Achieving and Maintaining Optimal Well-being UNDERSTANDING AND YOUR BODY. www.neorthopt.

STRESS. Health & Wellness The Newsletter About Achieving and Maintaining Optimal Well-being UNDERSTANDING AND YOUR BODY. www.neorthopt. Health & Wellness The Newsletter About Achieving and Maintaining Optimal Well-being UNDERSTANDING STRESS AND YOUR BODY Life s demands create stress and although some stress may be good, too much can cause

More information

Spinal Anatomy. * MedX research contends that the lumbar region really starts at T-11, based upon the attributes of the vertebra.

Spinal Anatomy. * MedX research contends that the lumbar region really starts at T-11, based upon the attributes of the vertebra. Spinal Anatomy Overview Neck and back pain, especially pain in the lower back, is one of the most common health problems in adults. Fortunately, most back and neck pain is temporary, resulting from short-term

More information

A review of spinal problems

A review of spinal problems Dr Ulrich R Hähnle MD, FCS Orthopaedic Surgeon, Wits Facharzt für Orthopädie, Berlin Phone: +27 11 485 3236 Fax: +27 11 485 2446 Suite 102, Medical Centre, Linksfield Park Clinic P.O. Box 949, Johannesburg

More information

A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH)

A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) Introduction Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a phenomenon that more commonly affects older males. It is associated

More information

Low Back Injury in the Industrial Athlete: An Anatomic Approach

Low Back Injury in the Industrial Athlete: An Anatomic Approach Low Back Injury in the Industrial Athlete: An Anatomic Approach Earl J. Craig, M.D. Assistant Professor Indiana University School of Medicine Department of Physical Medicine and Rehabilitation Epidemiology

More information

.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description

.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description Fractures of the Thoracic and Lumbar Spine Page ( 1 ) Spinal fractures can vary widely in severity. While some fractures are very serious injuries that require emergency treatment, other fractures can

More information

Headaches. Dr Simon Pumfrey 1 BSc MSc DC

Headaches. Dr Simon Pumfrey 1 BSc MSc DC Headaches Dr Simon Pumfrey 1 BSc MSc DC Dr Simon Pumfrey BSc MSc DC 2 3 Sick Care vs. Health Care Dr Simon Pumfrey BSc MSc DC Tension type Migraines Cervicogenic Cluster 4 Temporal arteritis Sinusitis

More information

A Look at Two Syndromes:

A Look at Two Syndromes: TEMPOROMANDIBULAR JOINT & CERVICOCRANIAL DYSFUNCTION IN THE EDS PATIENT John Mitakides D.D.S., FAACP A Look at Two Syndromes: How TMJ and CCD impact the EDS patient as they occur separately or together

More information

ICD-10 CM & Audits Dr. Karen Walters Graduated: New York Chiropractic College in 1982 Chiropractic & Physical Therapy clinic for over 25 years

ICD-10 CM & Audits Dr. Karen Walters Graduated: New York Chiropractic College in 1982 Chiropractic & Physical Therapy clinic for over 25 years ICD-10 CM & Audits Dr. Karen Walters Graduated: New York Chiropractic College in 1982 Chiropractic & Physical Therapy clinic for over 25 years Advised practice management consultants on setup & maintenance

More information

1 Operative Management of Common Spinal Conditions

1 Operative Management of Common Spinal Conditions 1 Operative Management of Common Spinal Conditions 2 Brett Menmuir Reno Orthopedic Clinic ROC Overview What was I thinking? Herniated Disc Stenosis Low Back Pain Neck Pain Sacroiliac Joint Dysfunction

More information

Mechanical Diagnosis And Therapy of the Cervical Spine. The McKenzie Method. Allan Besselink, PT, Dip.MDT Smart Sport International Austin, Texas

Mechanical Diagnosis And Therapy of the Cervical Spine. The McKenzie Method. Allan Besselink, PT, Dip.MDT Smart Sport International Austin, Texas Mechanical Diagnosis And Therapy of the Cervical Spine The McKenzie Method Allan Besselink, PT, Dip.MDT Smart Sport International Austin, Texas Background Physical Therapist Queen s s University 1988 McKenzie

More information

Chronic Headache Problem

Chronic Headache Problem Integrative Manual Therapy and Headaches In This Issue 2 HEADACHES Risk factors and what to do. 3 TIPS & TRICKS Exercises to minimize problems with headaches. 4 FAQ Most frequently asked questions about

More information

Patient Guide to Neck Surgery

Patient Guide to Neck Surgery The following is a sampling of products offered by Zimmer Spine for use in Anterior Cervical Fusion procedures. Patient Guide to Neck Surgery Anterior Cervical Fusion Trinica Select With the Trinica and

More information

The ICHD III Secondary Headaches

The ICHD III Secondary Headaches The ICHD III Secondary Headaches ICHD II Morris Levin, MD Professor of Neurology Professor of Psychiatry Dartmouth Medical School Co-Director, Dartmouth Headache Center Hanover, New Hampshire, USA ICHD

More information

THE TMJ TREATMENT CENTER

THE TMJ TREATMENT CENTER THE TMJ TREATMENT CENTER TEMPOROMANDIBULAR JOINT DISORDERS, CRANIOFACIAL DISORDERS, CERVICOCRANIAL INSTABILITY & EHLERS-DANLOS SYNDROME ABOUT DR. MITAKIDES & THE TMJ TREATMENT CENTER Dedicated to the diagnosis

More information

Differential Diagnosis of Chronic Headache

Differential Diagnosis of Chronic Headache Chronic Headache Differential Diagnosis of Chronic Headache JMAJ 47(3): 118 123, 2004 Koichi HIRATA Professor, Department of Neurology, Dokkyo University School of Medicine Abstract: Headache is one of

More information