ICD 10 CM Chapter Specific Guidelines I. C6

Dr. Lisa L Campbell®
3 Feb 201909:42
EducationalLearning
32 Likes 10 Comments

TLDRThis transcript offers a comprehensive review of ICD-10-CM Chapter 6 guidelines, focusing on coding for diseases of the nervous system (codes G000-G999). It discusses rules for coding paralysis based on dominant or non-dominant side, the use of G89 codes for pain not elsewhere classified, and exceptions to these rules. The importance of sequencing G89 codes with site-specific pain codes and the documentation requirements for post-operative pain and neoplasm-related pain are also highlighted. The video concludes with a discussion on chronic pain syndrome codes.

Takeaways
  • 📚 ICD-10-CM Chapter 6 covers diseases of the nervous system with a code range of G000 through G999.
  • 👨‍⚕️ Documentation should specify if paralysis affects the dominant or non-dominant side, or follow default rules if unclear.
  • 🤲 Default coding for ambidextrous patients is 'dominant', for left side is 'non-dominant', and for right side is 'dominant'.
  • 🌟 Category G89 codes are for pain not elsewhere classified and can be used with other categories for specificity.
  • ⚠️ Exceptions to using G89 codes include unspecified pain, post-thoracotomy pain, post-procedural pain, and neoplasm-related pain.
  • 🚫 Do not assign G89 codes if the underlying diagnosis is known, unless the encounter is for pain control or management.
  • 📈 G89 codes are not listed as principal or first listed unless the encounter is specifically for pain control or management.
  • 🔄 Sequencing rules for G89 codes involve considering the reason for the encounter and whether a definitive diagnosis is established.
  • 🩺 Post-operative pain should not be assigned with a specific post-op complication; follow provider's documentation for coding.
  • 📊 Chronic pain is classified under subcategory G89, with no specific timeframe, and should be guided by the provider's documentation.
  • 🌐 Neoplasm-related pain is coded as G89.3, used for both primary and secondary conditions, and can be principal or first listed.
Q & A

  • What is the ICD-10-CM Chapter 6 specific guideline being reviewed in the transcript?

    -The specific guideline being reviewed is for the diseases of the nervous system, which has a code range from G000 to G999.

  • How is the dominant and non-dominant side determined for a patient with paralysis in medical documentation?

    -The documentation typically identifies if the affected side is the dominant or non-dominant side. If the side is documented but not specified as dominant or non-dominant, and the coding manual doesn't provide a default, certain rules apply: if the patient is ambidextrous, the default is dominant; if the left side is affected, the default is non-dominant; and if the right side is affected, the default is dominant.

  • What is the general coding information for category G89 in the ICD-10-CM?

    -Category G89 is for pain not elsewhere classified and can be used with codes from other categories to provide more specific detail about acute or chronic pain, as well as situations when the patient has neoplasm-related pain, with some exceptions.

  • Under what conditions should a code from category G89 not be assigned?

    -A code from category G89 should not be assigned if the pain is not specified as acute or chronic, or if it's post-thoracotomy pain, post-procedural pain, or neoplasm-related pain. It also should not be used if the underlying diagnosis is known, unless the reason for the encounter is pain control or pain management, rather than the management of the underlying issue.

  • How should G89 codes be sequenced in relation to the reason for the encounter?

    -G89 codes should not be listed as the principal or first-listed diagnosis. They are only used when the patient is coming in for pain control or pain management, and the reason for the encounter is that particular condition.

  • Can G89 codes be used in conjunction with a site-specific pain code? If so, how should they be sequenced?

    -Yes, G89 codes can be used with site-specific pain codes. If the encounter is for pain control or pain management, the G89 code should be assigned first, followed by the specific site of pain. If the encounter is for any other reason, except pain control or management, and there's no related definitive diagnosis established by the provider, the site-specific code should be assigned first, followed by the G89 code.

  • What is the rule for documenting and coding post-operative pain in relation to specific post-op complications?

    -Post-operative pain should not be assigned with a specific post-op complication. Codes for injury, poisoning, or certain other consequences of external causes related to post-operative pain can be found in Chapter 19 of the ICD-10-CM guidelines.

  • How is chronic pain classified under the ICD-10-CM guidelines?

    -Chronic pain is classified under subcategory G89.2 to G89.9. There is no specific timeframe in determining when pain becomes chronic, and the provider should guide the use of these codes.

  • What is the code for neoplasm-related pain in the ICD-10-CM guidelines?

    -The code for neoplasm-related pain is G89.3, which describes pain that is documented or related to or associated with cancer, regardless of whether it's primary or secondary, or if it's a tumor.

  • When can the code G89.3 be assigned as the principal or first-listed diagnosis?

    -The code G89.3 can be assigned as the principal or first-listed diagnosis when the stated reason for the encounter is pain control or pain management, and then the underlying neoplasm is listed second.

  • What are the two specific chronic pain syndrome codes mentioned in the transcript, and when should they be used?

    -The two specific chronic pain syndrome codes are G89.0 for central pain syndrome and G89.4 for other chronic pain syndrome. These codes should only be used when the provider has specifically documented these two conditions.

Outlines
00:00
📚 ICD-10-CM Guideline Review: Nervous System Diseases and Coding

This paragraph introduces the focus of the video on ICD-10-CM guideline chapter six, which pertains to diseases of the nervous system (code range G00-G99). It discusses the coding rules for dominant and non-dominant sides in cases of patient paralysis, with default rules provided for when the documentation is unclear. The video also touches on the use of 'unspecified' codes for ambidextrous patients and specific defaults for left or right side affections. The segment concludes with a brief mention of the broad category of pain codes under G89, setting the stage for a deeper dive into coding practices for the nervous system.

05:02
📝 Detailed Coding Information for Nervous System Pain

The second paragraph delves into the specifics of coding for pain related to the nervous system, particularly under category G89. It explains the use of these codes in conjunction with other categories for acute or chronic pain, and exceptions to their use, such as when the pain is not specified or when the encounter is for a procedure aimed at treating the underlying condition. The paragraph also discusses the sequencing of G89 codes with site-specific pain codes, emphasizing the importance of following correct coding practices. It concludes with a discussion on post-operative pain coding and the classification of chronic pain and neoplasm-related pain, highlighting the conditions under which specific codes should be used and the importance of provider documentation in guiding the use of these codes.

Mindmap
Keywords
💡ICD-10-CM
The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is a medical coding system used in the United States for all medical diagnoses and procedures. In the video, it is the framework within which the discussion of Chapter 6, specific guideline six, is contextualized, focusing on diseases of the nervous system.
💡Dominant and Non-Dominant Side
Refers to the side of the body that is primarily used for tasks requiring motor skills, such as writing or sports. In medical documentation, specifying the affected side is crucial, especially in cases of paralysis. The video explains that if the documentation does not specify whether the affected side is dominant or non-dominant, there are default rules in the coding guidelines to determine this.
💡Paralysis
Paralysis is a condition where an individual loses the ability to move one or more limbs or body parts. In the context of the video, the discussion on paralysis is linked to the coding of the affected side, which is important for the accurate documentation and billing of medical conditions related to the nervous system.
💡Ambidextrous
Ambidexterity refers to the ability to use both the left and right hands equally well. In the video, it is mentioned as a default condition in coding guidelines for patients with paralysis when the dominant side is not specified, indicating that if a patient is ambidextrous, the default side affected would be considered dominant.
💡Category G89
Category G89 in the ICD-10-CM coding system refers to codes for pain, not elsewhere classified. These codes are used to describe pain conditions that do not fit into more specific categories. The video provides detailed guidelines on when and how to use these codes in conjunction with other codes to specify acute or chronic pain, as well as pain related to neoplasms.
💡Pain Management
Pain management involves the treatment and control of pain, often requiring a multidisciplinary approach. In the video, it is discussed as a criterion for using certain G89 codes, where the reason for the medical encounter is pain control or management, and not the management of the underlying condition causing the pain.
💡Sequencing of Codes
Sequencing of codes in medical documentation refers to the order in which diagnoses and procedures are listed, which can impact the prioritization of treatment and billing. The video provides detailed rules for sequencing G89 codes with other categories, emphasizing the importance of understanding the reason for the encounter to correctly sequence the codes.
💡Post-Operative Pain
Post-operative pain is the pain experienced after surgery. The video discusses the guidelines for coding post-operative pain, emphasizing that it should not be assigned with a specific post-operative complication unless guided by the provider's documentation.
💡Chronic Pain
Chronic pain is pain that persists beyond the normal healing time, often lasting for more than three months. In the video, chronic pain is differentiated from acute pain and is classified under subcategory G89, with specific codes provided for chronic pain and chronic pain syndrome.
💡Neoplasm-Related Pain
Neoplasm-related pain is pain associated with cancer, whether primary or secondary, or due to a tumor. The video discusses the use of code G89.3 for such pain, which can be used regardless of whether the pain is acute or chronic.
💡Chronic Pain Syndrome
Chronic pain syndrome is a complex, long-lasting pain condition that goes beyond the usual course of an injury or illness. The video distinguishes chronic pain syndrome from the general term 'chronic pain' and provides specific codes (G89.0 for central pain syndrome and G89.4 for other chronic pain syndrome) to be used only when these conditions are specifically documented by the provider.
Highlights

Today's focus is on ICD-10-CM Chapter 6 guideline review, specifically for diseases of the nervous system.

The code range for diseases of the nervous system is G000 through G999.

Dominant and non-dominant side rules are discussed for cases of patient paralysis.

If the affected side is not specified as dominant or non-dominant, default rules apply based on the patient's ambidexterity and the side affected.

Category G89 covers pain not elsewhere classified and can be used in conjunction with codes from other categories for acute or chronic pain.

There are exceptions to using G89 codes, such as when pain is not specified as acute or chronic, or when the underlying diagnosis is known.

G89 codes should not be used as the principal diagnosis unless the encounter is specifically for pain control or management.

For inpatient settings, 'principal' is used, while for outpatient or provider coding, 'first listed' is used.

G89 codes can be used in conjunction with site-specific pain codes to provide more detailed information about the pain.

Sequencing rules for G89 codes with site-specific pain codes depend on the reason for the encounter.

Post-operative pain should not be assigned with a specific post-op complication; it should be guided by provider documentation.

Chronic pain is classified under subcategory G89.2, with no specific timeframe for when pain becomes chronic.

Neoplasm related pain is coded as G89.3, used for pain associated with cancer or tumors, regardless of whether the pain is acute or chronic.

Chronic pain syndrome and central pain syndrome are specific conditions documented under G89.0 and G89.4, respectively.

The guidelines provide a structured approach to coding for diseases of the nervous system, emphasizing the importance of provider documentation.

Transcripts

Browse More Related Video

2023 ICD 10cm coding guidelines for chapter 6-diseases of nervous system

ICD-10-CM BootCamp: Diseases of the Nervous System

ICD 10 CM Chapter Specific Guidelines I. C5

ICD 10 CM Chapter Specific Guidelines I. C2

ICD-10-CM Specific Coding Guidelines - Neoplasms

ICD 10 CM Chapter Specific Guidelines I. C4

Rate This

5.0 / 5 (0 votes)

Thanks for rating:

Related Tags
Neurological CodingICD-10-CM GuidelinesPain ManagementParalysis DocumentationChronic PainCoding RulesMedical BillingHealthcare ComplianceDominant Side CodingAmbidextrous Considerations