Pain Management Coding Service

Welcome to CodeMatrix MedPartners LLC in Allen, TX, where we excel in pain management services coding. Our Revenue Cycle Management team is dedicated to providing comprehensive coding and medical billing services in pain management for qualified healthcare providers across the United States. Leveraging our medical coding services expertise, we ensure accurate and efficient processing of pain management procedures, resulting in streamlined reimbursements and maximum revenue outcomes.

According to a report by the Urgent Care Association, pain management is one of the primary reasons individuals seek medical attention at urgent care clinics, making it an essential aspect of medical coding for these facilities.

Pain Management Medical Coding Guidelines

Pain management medical coding is the process of assigning codes to medical services and procedures related to the diagnosis and treatment of pain. These codes are used by insurance companies, healthcare providers, and other entities for billing and reimbursement purposes. The codes are also used for tracking statistical data related to pain management.

The codes come from two primary classification systems: the International Classification of Diseases (ICD-10 ) and the Current Procedural Terminology (CPT). The former is a diagnostic code system used for reporting medical diagnoses, while the latter is a procedural code system that details specific services and procedures performed by healthcare professionals. Let’s review ICD and CPT codes in detail.


Common ICD-10-CM Codes for Pain Management

Pain Management CPT Codes

ICD-10-CM codes are important for accurately documenting a patient’s condition in the medical record. They enable healthcare professionals to classify and identify medical diagnoses, symptoms, and procedures.

There are a variety of ICD-10 codes that can be used depending on the type and cause of pain:

  • The most common ICD-10 code associated with chronic pain is M79.605, “Other chronic pain of unspecified site.”

Other codes that may be used are:

  • M54.5: Low Back Pain
  • M54.9: Unspecified Back Pain
  • G89: Chronic Pain Syndrome
  • F45.1: Somatoform Pain Disorder

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Pain Management CPT Codes

Pain management is a crucial part of patient care, especially for those living with chronic or terminal medical necessity. Coding for pain management is essential to ensure proper reimbursement and accurate record-keeping.

The American Medical Association (AMA) has released updated CPT codes for pain management in 2023, which provide more comprehensive coverage and improved accuracy when coding.

Frequent CPT Codes for pain management include:

• 99201-99215 – Office or other outpatient visits (initial visit)

• 99217-99220 – Hospital observation or inpatient services (postoperative pain management)

• 99324-99337 – Emergency department visits

• 99341-99350 – Home health care visits

• 97001-97762 – Physical therapy services

• 97530-97610 – Occupational therapy services (carpal tunnel syndrome)

• 97750-97755 – Speech-language pathology services

• 99354-99359 – Prolonged evaluation and management services

• 99361-99363 – Interprofessional telephone/e-consultations

• 99367-99368 – Group visits for health care services

• 99381-99387 – Preventive medicine services

• 99391-99392 – Inpatient consultation

• 98960-98968 – Administration of injections and immunizations (joint injection)

• G0281 – Interventional pain management (interventional techniques)

Chronic Care Management

Chronic Care Management (CCM) is an important part of pain management, as it helps to improve the quality of life for those living with chronic conditions. CCM provides patients with long-term crisis care and support to help them manage their health. It includes patient assessment, treatment planning, self-management education and support, coordination of services and care, and follow-up monitoring for any changes in the patient’s condition. Additional codes related to CCM include:

• 99490 – Chronic Care Management services, 20 minutes or more of medical evaluation and management service(s) provided to the patient by a physician or other qualified health care professional on the date of the initial CCM service

• 99487 – Complex chronic care coordination, 30 minutes or more of clinical staff time directed by a physician or other qualified health professional, in a calendar month, with the following required elements:

  • Face-to-face visit
  • Comprehensive assessment of the patient’s medical and psychosocial situation
  • Development of a comprehensive care plan
  • Education for both the patient and caregiver(s)
  • Oversight of the implementation of the care plan

• 99489 – Medical team conference, every 30 minutes or more of clinical staff time in a calendar month directed by a physician or other qualified health care professionals focused on managing the patient’s total care across multiple disciplines.

Pain management is an important part of health care and requires knowledge of the appropriate codes for both diagnosis and treatment. The accurate coding of pain management services is also essential to ensure that patients receive the care they need promptly.

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To ensure accuracy, it’s important to know which ICD codes are used to identify the diagnosis of the patient’s pain, as well as which CPT codes are used to document the medical care provided. Additionally, it’s important to understand the different types of chronic care management codes available and how they can be used to ensure that patients receive the appropriate services promptly.

CodeMatrix is a leading provider of pain management coding solutions for medical providers. Our dedication to proficient pain management coding, specialized procedural interventions, and meticulous medical coding exemplifies our unwavering commitment to elevating patient care within medical centers across the United States.

Partner with CodeMatrix for exceptional and efficient medical coding. Contact us today at (316) 519-4037 or email us at to explore the exclusivity of our coding services.

What our Clients say

Code Matrix has been collaborating with us as our offshore partner. Our billing is handled quickly and effectively, and they are always available to address any queries or issues.

My initial reservations about outsourcing our charge entry, payment posting, and accounts receivable were very strong, however your organization has eased my concerns. I am very happy with you guys!