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Topic Title: acute exacerbation of chronic "low back pain"
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Created On: 02/24/2010 02:39 PM

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 02/24/2010 02:39 PM
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Posts: 25
Joined: 02/01/2010

As I am reading through the guidelines, I am still unsure on how these are coded.

Would you specificy low back pain 7242 as admit and prin dx and then acute and chronic pain as secondary?

Thanks :)
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 02/25/2010 04:58 PM
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Posts: 312
Joined: 08/11/2005

I think you just need to study the part about sequencing which is in bold below and make your decision after you read this.

Use of Category 338 Codes in Conjunction with Site Specific Pain Codes

(i) Assigning Category 338 Codes and Site-Specific Pain Codes
Codes from category 338 may be used in conjunction with codes that identify the site of pain (including codes from chapter 16) if the category 338 code provides additional information. For example, if the code describes the site of the pain, but does not fully describe whether the pain is acute or chronic, then both codes should be assigned.

(ii) Sequencing of Category 338 Codes with Site-Specific Pain Codes
The sequencing of category 338 codes with site-specific pain codes (including chapter 16 codes), is dependent on the circumstances of the encounter/admission as follows:

· If the encounter is for pain control or pain management, assign the code from category 338 followed by the code identifying the specific site of pain (e.g., encounter for pain management for acute neck pain from trauma is assigned to 338.11, Acute pain due to trauma, followed by code 723.1, Cervicalgia, to identify the site of pain).
· If the encounter is for any other reason except pain control or pain management, and a related definitive diagnosis has not been established (confirmed) by the provider, assign the code for the specific site of pain first, followed by the appropriate code from category 338.
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