2025 ICD-10-CM code F45.4
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Mental, Behavioral and Neurodevelopmental disorders - Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders Chapter V: Mental and behavioural disorders Feed
Pain disorders related to psychological factors.
Not applicable to ICD-10 codes.
Medical necessity is established when a patient presents with pain disproportionate to an identifiable physical cause or when pain exists without a clear physical explanation, significantly affecting their daily life.Psychological factors must be identified and documented as significantly contributing to the pain.This may involve collaboration with mental health professionals for a comprehensive evaluation.
Diagnosis and management of pain disorders related to psychological factors involve a comprehensive evaluation of the patient’s history, symptoms, psychological state, and social factors. Treatment may involve collaboration with mental health specialists. The physician's role includes identifying and managing the pain, as well as addressing any underlying psychological issues that might be contributing to the pain.This can include medication management (antidepressants, anxiolytics, etc.) and possibly referring the patient to a therapist for psychological therapies (such as CBT).
- Chapter V: Mental and behavioural disorders
- F40-F48 (Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders)
In simple words: This diagnosis means your pain is mainly caused by emotional or mental problems like stress, anxiety, or depression.The pain might be more intense than expected for a physical problem, or you might have pain without a clear medical reason. Doctors use your story, symptoms, and a check-up to rule out other problems and figure out what's happening. Treatment may involve therapy to address the mental health concerns alongside medication or other pain-relief methods.
Pain disorders related to psychological factors encompass pain experiences significantly influenced by psychological factors like emotional distress, anxiety, depression, or distorted cognition.The pain may be disproportionate to any identifiable physical cause or exist without a clear medical explanation.Diagnosis considers patient history, symptoms, psychosocial assessment, and exclusion of other pain causes. Treatment often involves a multimodal approach, potentially including psychotherapy, antidepressants, anxiolytics, and non-narcotic pain relievers. The specific manifestations of pain and treatments vary depending on individual circumstances and the underlying psychological factors.
Example 1: A 35-year-old female presents with chronic lower back pain.Physical examination reveals no structural abnormalities.She reports significant anxiety and depression related to recent job loss and marital difficulties.Her pain is considered disproportionate to any identifiable physical cause and is likely influenced by psychological factors., A 28-year-old male reports persistent headaches that have worsened over the past six months.Neurological examinations and imaging are unremarkable.He expresses high levels of stress related to work pressures and financial instability. His pain is assessed as potentially related to these psychological stressors., A 60-year-old female experiences chronic abdominal pain.Extensive investigations, including endoscopy and colonoscopy, reveal no physical pathology.She has a history of anxiety and reports significant emotional distress related to the recent death of her spouse. Her pain is considered likely related to psychological factors.
Detailed patient history including psychosocial stressors and mental health history. Results of physical examination to rule out other causes. Psychological assessments to assess for depression, anxiety, or other relevant conditions. Documentation of pain intensity, location, duration, and impact on daily life.Documentation of treatment plan including any medications, therapies, and referrals to mental health professionals.
** The term "psychogenic pain" is outdated; it is preferable to use more holistic terminology that acknowledges the interplay of physical and psychological factors in pain experience.Consider using additional ICD-10 codes to capture any co-occurring mental health diagnoses or associated medical conditions.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Specialties:Psychiatry, Psychology, Pain Management, Family Medicine, Internal Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital,Other Place of Service