![]() ![]() A number of other options are available for those who do not improve with usual treatment. NSAIDs are recommended if these are not sufficiently effective. Non–medication based treatments include superficial heat, massage, acupuncture, or spinal manipulation. Initial management with non-medication based treatments is recommended. Normal activity should be continued as much as the pain allows. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40–90% of people recovered by six weeks. In those with chronic pain, the pain processing system may malfunction, causing large amounts of pain in response to non-serious events. ![]() Some low back pain is caused by damaged intervertebral discs, and the straight leg raise test is useful to identify this cause. Despite this, the use of imaging in low back pain has increased. In most cases, imaging tools such as X-ray computed tomography are not useful or recommended for low back pain that lasts less than 6 weeks (with no red flags) and carry their own risks. If the pain does not go away with conservative treatment or if it is accompanied by "red flags" such as unexplained weight loss, fever, or significant problems with feeling or movement, further testing may be needed to look for a serious underlying problem. In most episodes of low back pain, a specific underlying cause is not identified or even looked for, with the pain believed to be due to mechanical problems such as muscle or joint strain. The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. Low back pain may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks). Pain can vary from a dull constant ache to a sudden sharp feeling. Low back pain ( LBP) or lumbago is a common disorder involving the muscles, nerves, and bones of the back, in between the lower edge of the ribs and the lower fold of the buttocks. Usually non-specific, occasionally significant underlying cause Ĭontinued normal activity, non-medication based treatments, NSAIDs A coder should not assume that pain is due to an old facture without supporting documentation or confirmation from the clinician.Orthopedics, rheumatology, rehabilitation medicineĪcute (less than 6 weeks), sub-chronic (6 to 12 weeks), chronic (more than 12 weeks) X-ray reveals an old fracture but there is no other diagnosis of injury, can the pain be attributable to the old fracture?This scenario highlights a documentation issue, rather than a coding query and code assignment in this instance should be verified with the clinician. Paragraph 2 of this query cites a scenario where a patient is admitted with back pain following minor trauma (turning over in bed). ![]() If a fracture is documented as being associated with osteoporosis, then assign the appropriate code from category M80 Osteoporosis with pathological fracture. If in doubt, code assignment should be confirmed with the clinician.Osteoporosis causes severe weakening of the bones and can cause fractures, particularly lumbar fractures. To assign a pathological fracture code, the fracture must be either documented as 'pathological' or described as being 'due to a condition'. At the lead term fracture in the ICD-10-AM Alphabetic Index the term 'compression' is a nonessential modifier while the term 'crush' is not listed as either an essential or nonessential modifier.If there is no external cause of injury documented in the clinical record, and clarification is unable to be obtained from the clinician, assign X59 Exposure to unspecified factor as the external cause of injury code, following the pathway:įracture (circumstances unknown or unspecified) X59 Both crush and compression fractures, without further specification, should be coded to Fracture, by site. ![]()
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