New spine codes to further clarify back pain


New updates in the family of ICD-10-CM codes will provide further specifications for back pain.

The ICD-10 Coding Committee released a new set of diagnostic codes to specifically describe intervertebral disc degeneration with discogenic pain, a spokesperson for the International Society for the Advancement of Spine Surgery told Becker's. The payment rule was released April 10 and will take effect Oct. 1.

ISASS has advocated for these changes in the past. In 2023, the society requested an update during a public forum. Spine surgeon Morgan Lorio, MD, ISASS' chair of coding and reimbursement task force and incoming president, has been at the forefront of the push.

"The impact of these new ICD-10 codes for discogenic low back pain on spinal interventions and treatment is expected to be positive, leading to more personalized, effective, and accessible care for patients with spinal disorders," Dr. Lorio said. "These codes represent a significant advancement in the field that has the potential to benefit both patients and providers alike."

Dr. Lorio said in a statement to Becker's benefits of the new codes are:

1. Precision in diagnosis: Healthcare providers will have clearer criteria for diagnosing discogenic low back pain, allowing for more precise identification of the underlying pathology. This can guide treatment decisions and improve patient outcomes by ensuring that interventions are targeted to the specific cause of the pain.

2. Tailored treatment approaches: With a better understanding of the specific nature of discogenic low back pain, clinicians can tailor treatment approaches to individual patients. This may involve a combination of conservative therapies, minimally invasive procedures and surgical interventions, depending on the severity and characteristics of the condition.

3. Innovation and research: The availability of standardized codes can stimulate innovation and research in the field of spinal interventions. Researchers may be motivated to develop new techniques, devices and therapies aimed at addressing discogenic low back pain more effectively, knowing that there is a clearer pathway for reimbursement and utilization.

4. Expanded access to advanced therapies: Reimbursement pathways for disc restoration, regeneration, and arthroplasty can increase access to advanced therapies for patients with discogenic low back pain. This may include regenerative medicine techniques, motion-preserving implants and other cutting-edge interventions that were previously underutilized due to reimbursement barriers.

5. Improved documentation and communication: Standardized coding for discogenic low back pain enhances documentation and communication between healthcare providers, insurers and regulatory agencies. This can streamline administrative processes, facilitate accurate billing and reimbursement and ensure that patients receive appropriate care based on established guidelines and protocols.

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