Ch 9 nervous System

We rarely know,
if unspecified:
right hand defaults as dominant
left side defaults as non-dominant
ambidextrous patient = dominant

Dominant v. nondominant

Admission is for treatment of pain

Admission is for insertion of neurostimulator for pain control

​G89 first listed when...

Can be used to add acute/chronic, cancer pain, etc. IF THE DOCUMENTATION SAYS SO

Do not use if definitive dx is known unless reason for admission is pain management

G89 Pain NOS

Sequencing

-Admit for pain control- G89 first
-Admit for other reason, but we dont know definitive dx, only pain location and type, then code pain location first (ex: laparoscopy for chronic abdominal pain)
- Pain due to medical devices is coded elsewhere as a complication

Post op pain

Routine/expected - should not be coded
- G89 if its post op pain with no complication
- Post op pain with complication (painful wire sutures) gets a complication code, and then a G89 code

Neoplasm related pain G89.3 is used for cancer or tumor pain regardless of if the pain is acute or chronic

Dont forget the sequencing guidelines we went over in our Neoplasm chapter (its listed here too, for convenience)

Neoplasm Pain

Chronic pain is not the same as CPS (Chronic Pain Syndrome)

Chronic has no timeframe, rely on provider documentation

​Chronic

A specific disease
Can be with or without dementia

This is a G code, with an F code added if applicable

​Alzhiemers

a variety of symptoms such as loss of recent memories, language issues, deficient ADL abilities, personality changes,
loss of problem solving processes, visual delusions
This is an F code with a G code first if applicable

Dementia

Do not use the terms interchangeably

A single seizure event is a convulsion - R code
A seizure disorder, or recurrent seizures is Epilepsy - G code

Be careful with recurrent febrile seizures, this would still be an R code because the fever is causing the seizures and not a epileptic change in brain electricity

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