With ICD-10 changes right around the corner, we thought it would be helpful to put together a bit of a cheat sheet for our pelvic health providers. Keep in mind that this is only a guide, and that you and your facility should rely upon your own knowledge and skills. We hope this list makes getting to coding proficiency a little easier!
The Centers for Medicare and Medicaid Service have a website called “Road to 10” that is very helpful for learning about all the changes that are coming up very soon, starting with “ICD-10 Basics” (they even have a countdown clock, with seconds included- no pressure!) The site has some documents for physicians, which therapists might find somewhat useful, including ones called “Common Codes for OB/GYN" or "Common Codes for Orthopedics". The Herman & Wallace Pelvic Rehabilitation Institute has created for you the Common Codes for the Pelvic Rehab Provider, For those of us in pelvic rehabilitation, the more tools that we have to make the transition easier, the better.
There are 3 main things that are going to help with this transition: 1) knowing how ICD-10 is different than ICD-9, so that you are aware of the additional choices you may need to make, 2) having a comprehensive list of all the codes to choose from, and 3) having a shorter list of codes so you don’t have to move through the entire list!
If you need a primer on ICD-10, Rick Gawenda has done a great job of providing resources, including his courses on the MedBridge website. First, we will cover some how-to about navigating the websites and the lists. Next, we will give you some hints about avoiding the pitfalls of the new system. Finally, we present a short list of some “go-to” codes for most pelvic rehab providers. For great ICD-10 info, you can also check out WebPT’s blog and other resources on their site.
As for the cheat sheet, below are some of the top codes we use in pelvic rehab. For a much longer list, and more pages of information about resources to get you ready, download the Common ICD-10 Codes for the Pelvic Rehabilitation Practitioner document.
Coccygodynia (See Sacrococcygeal disorders, not elsewhere classified) M53.3
Constipation K59.0 Excludes1: fecal impaction (K56.41) incomplete defecation (R15.0)
Constipation, unspecified K59.00
Dysmenorrhea, unspecified N94.6 (Excludes1: psychogenic dysmenorrhea (F45.8))
Dyspareunia N94.1 (Excludes1: psychogenic dyspareunia (F52.6))
Fecal incontinence R15 (Includes: encopresis NOS Excludes1: fecal incontinence of nonorganic origin (F98.1))
Functional diarrhea K59.1 (Excludes1: diarrhea NOS (R19.7), irritable bowel syndrome with diarrhea (K58.0))
Incomplete defecation R15.0 (Excludes1: constipation (K59.0-) fecal impaction (K56.41))
Interstitial cystitis (chronic) N30.1
Irritable bowel syndrome Includes: irritable colon spastic colon K58
Irritable bowel syndrome with diarrhea K58.0
Irritable bowel syndrome without diarrhea (Irritable bowel syndrome NOS) K58.9
Low back pain (Loin pain, Lumbago NOS) M54.5 (Excludes1: low back strain (S39.012), lumbago due to intervertebral disc displacement (M51.2-), lumbago with sciatica (M54.4))
Mixed incontinence (Urge and stress incontinence) N39.46
Muscle spasm M62.83
- Other muscle spasm M62.838
Nocturnal enuresis N39.44
Lower abdominal pain, unspecified R10.30
Outlet dysfunction constipation K59.02
Overactive bladder (N32.81) (Detrusor muscle hyperactivity) (Excludes1: frequent urination due to specified bladder condition- code to condition)
Pain in hip M25.55
- Pain in right hip M25.551
- Pain in left hip M25.552
Pelvic and perineal pain R10.2 (Excludes1: vulvodynia (N94.81))
Pelvic Muscle Wasting N81.84
Post-void dribbling N39.43
Primary dysmenorrhea N94.4
Sacrococcygeal disorders, not elsewhere classified (Coccygodynia) M53.3
Sciatica M54.3 (Excludes1: lesion of sciatic nerve (G57.0) sciatica due to intervertebral disc disorder (M51.1-) sciatica with lumbago (M54.4-))
- Sciatica, right side M54.31
- Sciatica, left side M54.32
Secondary dysmenorrhea N94.5
Slow transit constipation K59.01
Stress incontinence (female) (male) N39.3 (Code also any associated overactive bladder) (Excludes1: mixed incontinence)
Urge incontinence (Excludes1: mixed incontinence (N39.46)) N39.41
Vaginismus N94.2 Excludes1: psychogenic vaginismus (F52.5)
Vulvar vestibulitis N94.810
Vulvodynia N9, unspecified
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