2025 ICD-10-CM code G89.12
(Valid) Effective Date: N/A Diseases of the nervous system - Other disorders of the nervous system 6 Feed
Acute post-thoracotomy pain. This condition describes the severe pain experienced after a thoracotomy (surgical incision of the chest wall) due to the cutting of ribs, joints, and nerves, lasting for less than three months.
Medical necessity for treating acute post-thoracotomy pain stems from the need to alleviate pain, optimize respiratory function, facilitate effective coughing and secretion clearance, and minimize the risk of postoperative pulmonary complications like atelectasis and pneumonia. Effective pain management is crucial for patient comfort, recovery, and preventing prolonged hospital stays.
Physicians diagnose acute post-thoracotomy pain based on patient history, presenting signs and symptoms, and physical examination findings. Managing this condition requires ensuring adequate pain control to facilitate deep breathing and effective coughing for clearing secretions, thus preventing potential respiratory complications.
In simple words: Acute post-thoracotomy pain is a sharp pain felt after chest surgery (thoracotomy) where the ribs, joints, and nerves are cut. This pain, which can last up to three months, makes it hard to breathe deeply and cough, sometimes leading to lung problems. Doctors diagnose it based on the surgery, symptoms, and a physical exam. Treatment involves pain relief to help patients breathe and cough better.
Acute post-thoracotomy pain arises after a surgical incision into the chest wall (thoracotomy), damaging bones, joints, and nerves. It leads to intense pain in the chest wall and shoulder on the affected side, accompanied by breathing difficulties, particularly during inspiration. This can trigger reflexive expiratory muscle contraction, diaphragm dysfunction, reduced functional residual lung capacity (the air volume remaining in the lungs after exhalation), and hypoxia (low blood oxygen levels). The pain associated with deep breathing hinders effective coughing and secretion clearance, potentially causing atelectasis (lung collapse or incomplete expansion). Diagnosis involves evaluating the patient's history of thoracotomy, alongside their symptoms and a physical examination. Treatment focuses on effective pain management to enable deep breathing and forceful coughing for secretion expulsion.
Example 1: A patient undergoes a thoracotomy for lung cancer removal. In the days following the surgery, they experience intense pain at the incision site, radiating to their shoulder, making it difficult to take deep breaths. This pain, diagnosed as acute post-thoracotomy pain, is managed with pain medication to enable effective coughing and prevent pneumonia., Following a thoracotomy for a heart valve repair, a patient develops acute post-thoracotomy pain. The pain limits their ability to breathe deeply and cough, resulting in partial lung collapse. Pain management, including intercostal nerve blocks and opioids, is implemented to improve respiratory function and prevent further complications., A patient who underwent a thoracotomy for a chest injury experiences persistent, sharp pain along the incision line two weeks post-surgery, accompanied by shallow breathing.They are diagnosed with acute post-thoracotomy pain, and a combination of physical therapy and pain medication is prescribed to manage the pain and restore full lung function.
Documentation should include the type of thoracotomy performed, the location of the pain, the severity and character of the pain, any associated symptoms (e.g., difficulty breathing, limited cough), and the impact on respiratory function. Treatment details, including pain management strategies and their effectiveness, should also be recorded.
- Specialties:Thoracic surgery, pain management, anesthesiology, pulmonary medicine
- Place of Service:Inpatient Hospital