ICD Diagnosis Codes For Pain Management: What to Know In 2024

icd 10 diagnosis code pain management

Examining pain disorders exclusively related to psychological factors requires a complex understanding, especially with the changes implemented on October 1, 2023, set by the 2024 edition of ICD-10-CM. This essential shift, applicable to annotations and deeply rooted in the American ICD-10-CM version, significantly impacts the coding and billing processes for chronic pain management.

As we delve into the complexities of coding, distinguishing between acute and chronic pain, exploring common diagnoses, and understanding diagnostic assessment coding, it becomes evident that staying abreast of these updates is crucial for healthcare professionals. 

Defining Pain

Pain can be classified into two types, namely acute pain and chronic pain.  

The two can be differentiated on the basis of the duration that it takes to resolve. The ones that resolve along with the recovery of the body are called acute pain, but the pain that persists for a longer duration of time and takes much longer is called chronic pain.  

  • Basic coding descriptions and terminology for chronic pain
  • Common Diagnosis
  • Diagnostic Assessment Coding

Coding Chronic Pain

Coding chronic pain depends on various factors, which can be grouped under: 

  • Basic coding descriptions and terminology for chronic pain  
  • Common Diagnosis
  • Diagnostic Assessment Coding

Basic Coding Descriptions and Terminology

Something that forms the basis of coding chronic pain correctly, is the basic knowledge about the anatomical terminologies. A few examples of this would be mono for unilateral and bi for bilateral. Another term would involve the region of the body, such as the lumbar, which would be the lower part of the back.

It is also important to note that many procedures are not straightforward and are coded based on depth and location. An example of this would be laceration repair. Not only would the coder need to know the location of the repair, but also the depth, such as subcutaneous or fascia, along with the size of the laceration.

Chronic pain can also be experienced in any part of the body, but there are few common locations where chronic pain is most commonly found:  

  • Joint pain.  
  • Back pain.  
  • Neck pain.  
  • Cancer pain near a tumor.  
  • Headaches, including migraines.  
  • Testicular pain (orchialgia).  
  • Lasting pain in scar tissue.  
  • Muscle pain all over (such as with fibromyalgia).  
  • Neurogenic pain, from damage to the nerves or other parts of the nervous system.  

Now let’s examine the ICD Codes for pain management.  

icd 10 code for pain management

ICD 10 Code For Pain Management

Common Primary Chronic Pain Diagnosis Codes
ICD-10-CM Description
G89.21 Chronic pain due to trauma
G89.28 Other chronic postprocedural pain
G89.29 Other chronic pain
G89.4 Chronic pain syndrome
Common Secondary Chronic Pain Diagnosis Codes
ICD-10-CM Description
G90.511 Complex regional pain syndrome I of right upper limb
G90.512 Complex regional pain syndrome I of left upper limb
G90.513 Complex regional pain syndrome I of upper limb, bilateral
G90.521 Complex regional pain syndrome I of right lower limb
G90.522 Complex regional pain syndrome I of left lower limb
G90.523 Complex regional pain syndrome I of lower limb, bilateral
G90.529 Complex regional pain syndrome I of unspecified lower limb
G90.59 Complex regional pain syndrome I of other specified site
G89.0 Central pain syndrome
G96.12 Meningeal adhesions, spinal, cerebral
G54.0 Brachial plexus disorders
G54.1 Lumbosacral plexus disorders
G54.6 Phantom Limb Syndrome; with pain
G54.8 Other nerve root and plexus disorders
G54.4 Lumbosacral root disorders, not elsewhere classified
G56.40 Causalgia of upper limb, unspecified
G56.41 Causalgia of right upper limb
G56.42 Causalgia of left upper limb
G56.80 Other specified mononeuropathies of unspecified upper limb
G56.90 Unspecified mononeuropathies of unspecified upper limb
G56.91 Unspecified mononeuropathies of right upper limb
G56.92 Unspecified mononeuropathies of left upper limb
I70.229 Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
M54.12 Radiculopathy, cervical region
M54.13 Radiculopathy, cervicothoracic region
M54.14 Radiculopathy, thoracic region
M54.15 Radiculopathy, thoracolumbar region
M54.16 Radiculopathy, lumbar region
M54.17 Radiculopathy, lumbosacral region

Other Issues Caused by Chronic Pain

Chronic pain can also cause certain behavioral health issues such as:

  • Anxiety.
  • Depression.
  • Fatigue, or feeling overly tired most of the time.
  • Insomnia, or trouble falling asleep.
  • Mood swings.
These behavioral health issues may lead to Behavioral assessment testing

Diagnostic Assessment Coding

Some chronic care management may involve diagnostic assessments. This may be done for patients with chronic conditions such as dementia and ADHD. Some of the terminology for these codes will include Psychological or neuropsychological. Psychologists focus more on emotions, while neuropsychologists focus on neurobehavioral disorders, cognitive processes, and brain disorders.

Behavioral Assessment Testing

Behavioral assessment testing is done to explain and predict behavior. An example of this testing would be assessing the emotions and behavior of a patient for mental health disorders such as depression or attention–deficit/hyperactivity disorder. This is when the provider scores on the various tests administered and documents the results.

Here are some examples of related coding:   

  • Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation per standardized instrument (96160)  
  • Neuropsychological testing evaluation services by physician or other qualified healthcare professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed (96132 for first hour and 96133 for each additional hour)  
  • Physical performance test or measurement (eg, musculoskeletal, functional capacity), with a written report (97750 for each 15 minutes)  
  • Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded R-R interval, Valsalva ratio, and 30:15 ratio (95921)  

Not all insurance will recognize nor pay for these codes. Or they may cover only a portion of mental health and behavioral services. It is vital to do pre-authorization checks to ensure eligibility. 


As you can see, medical coding and billing for Chronic Pain Management is very complex, with codes scattered between Category I and Category III of the AMA CPT codebook. It is essential that your coding team stay up to date on the latest coding changes and that coding audits are conducted on a regular basis to improve coding accuracy and consistency.

Neolytix has been helping healthcare organizations improve revenue cycle management, which includes coding and billing, for almost 12 years. Schedule a demo today to see how we can help your organization improve reimbursements and optimize operations.

Schedule A Consultation Today!

  • What EHR are you using to bill claims to Insurance companies, store patient notes.
  • This field is for validation purposes and should be left unchanged.

Stay ahead of the curve & join our provider community to get updated on the latest industry trends.

Newsletter (Active)

Homepage Asset Icon 16
Homepage Asset Icon 17
Form Image

Get your free intuitive, Fast Facts for Pain Management Coding Flash Guide now!

This field is for validation purposes and should be left unchanged.