Resolved Post Op Infection

[MaryW_64032]

Pt Comes in with pain after perineorrhaphy (did not give birth nor is pt pregnant) final post op infection unspecified type.
for the final would you code T8140xa, T81.49 or N9989? Thank you

 

[Lori]

Only when postoperative pain is documented to present beyond what is routine and expected for the relevant surgical procedure is it a reportable diagnosis. Postoperative pain that is not considered routine or expected further is classified by whether the pain is associated with a specific, documented postoperative complication.

Postoperative pain not associated with a specific postoperative complication is reported with a code from Category G89, Pain not elsewhere classified, in Chapter 6, Diseases of the Nervous System and Sense Organs.

G89.18
Other acute post-procedural pain

T81.49XA (you know the complication is infection)
Infection following a procedure, other surgical site


N99.89 (Is an unknown or an unspecified complication)
Other postprocedural complications and disorders of genitourinary system

Coding for Postoperative Pain in ICD-10-CM

Postoperative pain typically is considered a normal part of the recovery process following most forms of surgery. Such pain often can be controlled using

www.icd10monitor.com

 

[WhitneyH_24046]

thanks!