ICD-10 Code F45.42

The ICD-10-CM code F45.42 is defined as "pain disorder with related psychological factors." This code is used to classify conditions where pain is the predominant focus of clinical attention and is significantly influenced by psychological factors. This diagnosis is essential for medical providers to accurately document and manage conditions where psychological factors play a critical role in the patient's experience of pain.

F45.42 is designated for pain disorders that are primarily associated with psychological factors. This means that while the patient experiences real physical pain, the intensity, exacerbation, or persistence of the pain is significantly influenced by psychological factors such as stress, anxiety, or depression. This code is particularly useful in identifying patients who may benefit from a biopsychosocial approach to pain management, integrating physical treatment with psychological support.

Patients diagnosed with F45.42 often report chronic pain that does not fully align with identifiable medical conditions or injuries. Symptoms can include:

It is important to distinguish F45.42 from other related ICD-10 codes, such as:

Each of these codes addresses different aspects of somatoform and pain disorders, highlighting the need for precise coding based on the patient's specific presentation.

When using F45.42 for billing, it is critical to ensure that the diagnosis is documented by the provider in the assessment portion of the note. The documentation should clearly indicate that the primary issue is pain with a significant psychological component. Providers might include notes from psychological assessments, pain evaluations, and evidence of how psychological factors influence the pain experience. Proper usage of this code supports the justification for a comprehensive treatment plan that may include both medical and psychological interventions.

For accurate coding with F45.42, follow these guidelines:

When coding with F45.42, refer to the instructional notes in the ICD-10 manual:

For further guidance on coding with F45.42, consider the following resources:

ICD-10-CM code F45.42 is used for accurately diagnosing and managing pain disorders influenced by psychological factors. Proper documentation, adherence to coding guidelines, and a multidisciplinary approach are important for effective patient care and accurate billing. By understanding the nuances of this code, healthcare providers can ensure comprehensive treatment plans that address both the physical and psychological aspects of pain.

Tebra’s EHR+ gives you quick searches and Systematized Nomenclature of Medicine (SNOMED) field names for efficient code documentation. Plus, Tebra automatically saves ICD-10 to SNOMED mapping for future searches, streamlining your workflow.

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