a Postoperative pain not associated with specific postoperative complication

A postoperative pain not associated with specific

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(a) Postoperative pain not associated with specific postoperative complication Postoperative pain not associated with a specific postoperative complication is assigned to the appropriate postoperative pain code in category G89. (b) Postoperative pain associated with specific postoperative complication Postoperative pain associated with a specific postoperative complication (such as painful wire sutures) is assigned to the appropriate code(s) found in Chapter 19, Injury, poisoning, and certain other consequences of external causes. If appropriate, use additional code(s) from category G89 to identify acute or chronic pain (G89.18 or G89.28). 4) Chronic pain Chronic pain is classified to subcategory G89.2. There is no time frame defining when pain becomes chronic pain. The provider’s documentation should be used to guide use of these codes. 5) Neoplasm related pain Code G89.3 is assigned to pain documented as being related, associated or due to cancer, primary or secondary malignancy, or tumor. This code is assigned regardless of whether the pain is acute or chronic. This code may be assigned as the principal or first-listed code when the stated reason for the admission/encounter is documented as pain control/pain management. The underlying neoplasm should be reported as an additional diagnosis. When the reason for the admission/encounter is management of the neoplasm and the pain associated with the neoplasm is also documented, code G89.3 may be assigned as an additional diagnosis. It is not necessary to assign an additional code for the site of the pain. See Section I.C.2 for instructions on the sequencing of neoplasms for all other stated reasons for the admission/encounter (except for pain control/pain management). 6) Chronic pain syndrome Central pain syndrome (G89.0) and chronic pain syndrome (G89.4) are different than the term “chronic pain,” and therefore codes should only be used when the provider has specifically documented this condition. See Section I.C.5. Pain disorders related to psychological factors Tests are performed to investigate the source of the patient’s chronic epigastric abdominal pain R10.13 Epigastric pain G89.29 Other chronic pain Explanation : In this instance the patient’s epigastric pain is not being treated; rather the source of the pain is being investigated. A code from chapter 18 for epigastric pain is sequenced before the additional specificity of the G89 code for the chronic pain. Pain pump dose is increased for the patient’s unexpected, extreme pain post-thoracotomy G89.12 Acute post-thoracotomy pain Explanation : When acute or chronic is not documented, default to acute. The use of “unexpected, extreme” and the increase of medication dosage indicate that the pain was more than routine or expected.
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