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B02.29
ICD-10-CM
Postherpetic Neuralgia

Find information on Postherpetic Neuralgia diagnosis, including ICD-10 code G53.2, clinical documentation requirements, pain management, treatment options, and healthcare provider resources. Learn about the connection between shingles and PHN, diagnostic criteria, and best practices for medical coding and billing. Explore resources for patients and healthcare professionals dealing with Postherpetic Neuralgia symptoms, long-term care, and prognosis.

Also known as

PHN
Herpetic Neuralgia
Post-herpetic Neuralgia
+1 more

Diagnosis Snapshot

Key Facts
  • Definition : Nerve pain persisting after shingles rash heals.
  • Clinical Signs : Burning, stabbing pain, sensitivity to touch, itching, numbness.
  • Common Settings : Primary care, pain clinics, neurology.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC B02.29 Coding
B02.2-

Herpes zoster with postherpetic neuralgia

Pain persisting after herpes zoster infection.

B02.0-B02.9

Herpes zoster

Viral infection causing painful rash and blisters.

G54.0-G54.9

Pain in limb

Nerve pain affecting the arms or legs, sometimes from postherpetic neuralgia.

M79.2

Neuralgia, neuritis and radiculitis

Generalized nerve pain, which postherpetic neuralgia is a type of.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the neuralgia following herpes zoster?

  • Yes

    Is the zoster site specified?

  • No

    Do NOT code as postherpetic neuralgia. Consider other neuralgia codes.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Pain after shingles rash
Trigeminal neuralgia
Diabetic neuropathy

Documentation Best Practices

Documentation Checklist
  • Hx of herpes zoster/shingles
  • Pain persists >3 months after acute rash
  • Location corresponds to dermatomal distribution
  • Detailed pain characteristics documented
  • Neuro exam findings if applicable

Coding and Audit Risks

Common Risks
  • Unspecified Zoster

    Coding PHN without documented history of herpes zoster (B02.x) may lead to claim denial. Proper CDI and query are crucial.

  • Incorrect PHN Code

    Using unspecified pain codes instead of G53.2x for PHN can result in inaccurate reporting and lost revenue. Coder training is essential.

  • Unconfirmed Diagnosis

    Lack of clear documentation supporting PHN diagnosis by the provider creates compliance risks and potential audit failures. Review clinical indicators.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding (G53.2x) for PHN is crucial for reimbursement.
  • Thorough documentation of pain characteristics improves CDI and patient care.
  • Timely antiviral therapy for herpes zoster reduces PHN risk. HCC coding impacts RAF scores.
  • Pain management plans, including medication and therapies, must be documented for compliance.
  • Regular patient follow-up and reassessment optimize PHN management and coding accuracy.

Clinical Decision Support

Checklist
  • Hx of herpes zoster rash dermatomal distrib
  • Pain persists >90 days after rash onset
  • Exclude other causes of neuropathic pain
  • Document pain characteristics location intensity
  • Neuro exam sensory deficits in affected area

Reimbursement and Quality Metrics

Impact Summary
  • Postherpetic Neuralgia reimbursement hinges on accurate ICD-10 (G53.2x) and CPT coding for procedures like nerve blocks, medication management, and other therapies. Impacts:
  • Coding errors delay payments and reduce revenue. Proper CPT modifier use (e.g., -59, -25) crucial.
  • Quality metrics: Pain management, functional status improvement, patient satisfaction influence value-based reimbursement.
  • Timely documentation and accurate coding optimize reimbursement and reflect quality of PHN care.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code G53.2x for PHN
  • Document persistent pain
  • Link PHN to prior zoster
  • Specify dermatomal distribution
  • Note pain duration >3 months

Documentation Templates

Patient presents with complaints consistent with postherpetic neuralgia (PHN) following a resolved episode of herpes zoster (shingles).  Onset of pain was approximately [number] weeks ago, corresponding to the healing of the shingles rash located on the [location of rash, e.g., left thoracic dermatome].  The patient describes the pain as [quality of pain, e.g., burning, stabbing, shooting] and reports allodynia and hyperalgesia in the affected area.  Pain severity is reported as [pain scale rating, e.g., 7/10 on the numerical rating scale] and significantly impacts activities of daily living, including [list affected activities, e.g., sleep, dressing, work].  Physical examination reveals [objective findings, e.g., mild erythema, no active vesicles, light touch eliciting pain response].  Diagnosis of postherpetic neuralgia is confirmed based on clinical presentation, history of shingles, and duration of pain exceeding three months post-rash resolution.  Differential diagnoses considered included diabetic neuropathy, post-traumatic neuralgia, and musculoskeletal pain.  Treatment plan includes initiation of [medication, e.g., gabapentin] titrated to effect for neuropathic pain management.  Patient education provided on postherpetic neuralgia, medication side effects, and coping strategies for chronic pain.  Follow-up appointment scheduled in [timeframe, e.g., two weeks] to assess treatment response and adjust therapy as needed.  ICD-10 code: G53.22.  Referral to pain management specialist will be considered if symptoms do not improve with initial therapy.