Editor's Note: The following is excerpted from Sam Collins' upcoming article on the latest ICD-10 code updates.
As occurs every Oct. 1, there are updates to the ICD-10 coding system. Some years, this makes no difference to the common codes billed by acupuncture providers, but most years there are at least a few changes that do; and this year, like last year, does so, particularly the code for which most insurances, including Medicare, will reimburse acupuncture services.
This year, the code for back pain was updated. M54.5 was deleted and replaced with three new codes:
M54.50, Unspecified back pain, in simplest terms, means there is back pain, but no specific causation or reason identified. This code is the most likely used for acupuncture providers, as it is not attempting to define based on a Western nomenclature; and avoids an issue of using a differential or Western diagnosis by simply defining the pain.
M54.51 Vertebrogenic back pain is to identify pain related to a vertebra or the spine. It does not specifically identify the exact disease or condition. However, some examples include vertebral endplate pain. Some codes would or could be more specific to the spinal nature of pain in the lower back, such as sprain, strain, radiculopathy, etc., which can be used for a more specified identification; but this is a generic version to indicate broadly spine related.
M54.59 Other back pain would be used if the specific cause can be identified, but otherwise has no specific code. Unlike codes that state "unspecified," this code means you can specify the origin. For example, internal or visceral causation, like a kidney stone causing back pain, would be an appropriate use of this code.
Another Code for headache
There is an additional, less publicized (but equally important) covered diagnosis for acupuncture; a new code for headache: cervicogenic headache G44.86. This represents a further identification of the types of headaches, specifying cervicogenic as an origin or cause. Note there are multiple codes for headaches including specific diagnoses: migraine, tension, traumatic, vascular, cluster, etc.
Cervicogenic relates to pain that develops in the neck, although it is felt in the head. Cervicogenic headaches are secondary headaches, meaning there is specific underlying causation from the neck, which may include muscle tension.
Editor's Note: Look for Sam's full article (December issue) to learn about other ICD-10 code changes and additional information on billing for acupuncture practitioners.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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