The new year will bring plenty of CPT® code changes for pain management, and physicians, coders, billers and office managers need to be on the lookout for changes to codes for remission, spinal stenosis and types of pain, in particular.
Pain management specialist Amy Turner recently explained the changes in a conference for ProfEdOnDemand, “2018 CPT® and ICD-10 Updates for Pain Management.” Turner highlighted code additions, deletions and revisions, and offered insider tips on documentation and modifier use issues as well as issues which result in denials.
ICD-10 Codes Proliferate
New ICD-10 codes impacting pain management, said Turner, include: abuse remission for alcohol (F10.11), opioids (F11.11), cannabis (F12.11), sedative, hypnotics or anxiolytics (F13.11), cocaine (F14.11), other stimulants (F15.11), hallucinogens (F 16.11), inhalants (F18.11) and other psychoactive substances (F19.11).
For lumbar spinal stenosis, there are two additional codes:
- 061: Spinal stenosis, lumbar region without neurogenic claudication
- 062: Spinal stenosis, lumbar region with neurogenic claudication
There is also one deleted code: M48.06, for spinal stenosis, lumbar region.
Turner also noted a host of codes for G89—Pain not elsewhere classified. They include:
- 0: Central pain syndrome
- 1: Acute pain, not elsewhere classified
- 2: Chronic pain, not elsewhere classified
- 3: Neoplasm related pain (acute) (chronic)
- 4: Chronic pain syndrome
To use a code in the G89 series, pain must be specified as acute or chronic, post-thoracotomy, post-procedural or neoplasm-related.
For example, Turner said a patient presenting for evaluation and refills of a medication for chronic neck pain would be coded G89.29: Other chronic pain, and M54.2: Cervicalgia, with the reason for the visit listed as pain control or pain management.
For G56.0: Carpal tunnel syndrome and G57.1: Meralgia paresthetica, Turner noted that there are left, right and bilateral codes.
CPT® Code Changes by Region
Several 2017 changes went into effect over the summer, Turner pointed out. Starting July 1, practitioners in Kentucky, Florida, Nevada, New Jersey, North Dakota, Ohio, Oregon and Rhode Island were required to use CPT® code 99024 when reporting claims data on post-operative visits furnished during the global period of specified procedures.
“Intraservice time” makes several appearances for 2018—the period begins at the administration of the sedative and ends when the procedure ends. To report, there must be at least 10 minutes of moderate sedation—use code 99152. Each additional 15 minutes of intraservice time gets code 99153.
In all, said Turner, there’s plenty to prepare for as billers and coders in the area of pain management move toward 2018.
