tci Outpatient Facility Coding Alert - 2019 Issue 1

Reader Question: Note Circumstances of Postop Pain Before Determining Dx Code

Question: A patient is seen by the physician two days following an ethmoidectomy. The patient complains of pain in and around the ethmoid sinus. What diagnosis code should I use to report this condition? Arizona Subscriber Answer: You’ll want to consider the circumstances surrounding the patient’s pain to guard against incorrectly reporting a diagnosis code such as J34.89 (Other specified disorders of nose and nasal sinuses). Since this is a postoperative symptom, you should report the patient’s pain diagnosis accordingly. The 2019 ICD-10-CM guidelines instruct you to report a postoperative pain code from category G...

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