Neurology & Pain Management Coding Alert
Code Sets Include New Diagnoses for Parkinson’s, Migraine
Epilepsy codes get a new category in 2024. The team at ICD-10 has released the new code list for 2024, and neurology and PM coders now have to familiarize themselves with the new codes. The skinny: The ICD-10 2024 addendum includes about 500 new codes, with another 30 or so revised codes and some codes converted to parents. There’s plenty for neurosurgery coders to digest before the new codes become effective on Oct. 1, 2023. Here are the new codes you should be focusing on to be prepped for ICD-10 2024. Meet the ‘Parents’ The first new codes we’ll cover come under already-existing codes that have been converted to parent codes. When a code is converted to parent code, it expands the coding possibilities under that particular diagnosis code by adding new codes with greater specificity below it. Check out these parent code conversions, along with their new code families: Converted to Parent New Codes Analysis: Remarkably, G20 was the only code for Parkinson’s disease in the ICD-10 code book before 2024. These updates will make Parkinson’s coding more specific by adding information about dyskinesia and fluctuations. According to Gregory Przybylski, MD, Chairman of Neuroscience at the New Jersey Neuroscience Institute, JFK University Medical Center in Edison, New Jersey, any expansion of the Parkinson’s codes is a positive. “Greater specificity in Parkinson’s disease is helpful in tracking treatments of this condition. Given that Parkinson’s disease has several manifestations in a patient’s condition and function, greater granularity in the diagnosis codes will help track how the various manifestations of Parkinson’s disease responds to various treatments,” he says. Converted to Parent New Codes Analysis: This is a relatively minor change, but it will make reporting myelin oligodendrocyte glycoprotein antibody disease possible. Epilepsy, Migraine Get New Code Sets In addition to the new parent codes, coders will want to note some completely new sets that will appear in ICD-10 2024. New Codes Analysis: These additions provide another layer to the G40.- (Epilepsy and recurrent seizures) code group, which is already considerable. It represents a type of epilepsy that didn’t previously have specific codes; and these codes account for intractable/not intractable and with/without status epilepticus. For those unfamiliar with the condition, Lafora progressive myoclonus epilepsy is a type of epilepsy characterized by seizures and progressive neurological deterioration. It is a rare genetic disorder that usually begins in adolescence and is caused by mutations in certain genes. The seizures in Lafora progressive myoclonus epilepsy are often myoclonic, which means they involve sudden, brief muscle jerks. Other symptoms may include cognitive decline, difficulty with coordination and balance, and visual hallucinations. New Codes Analysis: Much like the new epilepsy codes, the new migraine codes add another layer to the already deep field of G43.- (Migraine) codes. Before 2024, chronic migraine with aura did not have its own code set. In 2024, you’ll be able to code for chronic migraine with aura, and you can further specify that diagnosis by answering the intractable/not intractable and status migrainosus questions. Remember, chronic migraine is a condition characterized by the presence of a headache on 15 or more days per month for at least three months, with at least eight of those headaches being migraines. Also, migraine with aura refers to a set of neurological symptoms that some individuals experience before or during a migraine. These symptoms typically occur gradually and can last for a few minutes to an hour. Migraine aura can manifest as various sensory disturbances, such as visual changes (flashing lights, blind spots, zigzag lines), tingling or numbness in the face or limbs, difficulty speaking, or even temporary loss of vision. Remember to Mark These Osteoporosis, Toxic Effect Codes Your PM clinic might see patients with osteoporosis, and it definitely performs magnetic resonance imaging (MRI) for patients. Therefore, you should also note these new codes for 2024: New Codes Analysis: These codes add further anatomical specificity to the pathological fracture ICD-10 codes. previously, there was no way to specify that the fracture was to the patient’s pelvis. Definition: Remember, a pathological fracture is a type of fracture that occurs in a bone that has been weakened by an underlying disease or condition. It is different from a typical fracture that occurs due to trauma or injury. In a pathological fracture, the bone breaks more easily because it has been compromised by an existing condition, such as osteoporosis or a tumor. New Codes Analysis: These codes reside in Chapter 19: “Injury, Poisoning, and Certain Other Consequences of External Causes.” More specifically, they will be part of the T56.8- (Toxic effects of other metals) code set. Definition: Gadolinium is a rare earth metal that is commonly used in medical imaging procedures, specifically in MRI. Gadolinium-based contrast agents (GBCAs) are injected into the patient’s bloodstream to enhance the visibility of certain tissues or blood vessels during an MRI scan. These contrast agents contain gadolinium ions that interact with the magnetic field of the MRI machine, producing a clearer and more detailed image.
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