Neurology & Pain Management Coding Alert

Patients with demyelinating diseases of the central nervous system (CNS) are common in a neurology practice. When coders are trying to choose ICD-10 codes for these patients, they have to look to a certain code set.

Which one? The codes you’ll select from reside in the “Demyelinating diseases of the central nervous system (G35-G37)” of ICD-10.

Read on for information on reporting each of these diagnosis codes.

Use G35 for MS

The most common, and well-known, disease in the G35-G37 code set is multiple sclerosis (MS). The major symptoms of MS are “vision problems including blurred vision, red-green color blindness, or blindness in one eye, muscle weakness in the extremities, coordination and balance problems, numbness, tingling, or prickling sensations, and depression,” according to Codify by AAPC. MS patients might also experience pain, tremors, and dizziness.

“Some patients may lose the ability to write, speak, walk, or stand; some may develop partial or complete paralysis. Mild difficulty concentrating and focusing, and impaired memory and cognitive function may be present,” according to Codify.

You’ll report MS diagnoses with G35 (Multiple sclerosis). Alternate terms that you might see that are also diagnosed with G35 are:

• Disseminated multiple sclerosis
• Generalized multiple sclerosis
• Multiple sclerosis NOS
• Multiple sclerosis of brain stem
• Multiple sclerosis of cord

Use G36.- for Other Acute Disseminated Demyelination

After G35, ICD-10 breaks the code family into two more “parents.” Read on for a breakdown of these two code families.

The first code set is G36.- (Other acute disseminated demyelination), for other acute disseminated demyelination. “Other acute disseminated demyelination refers to nervous system disorders not represented by another code that are caused by damage to the protective covering (myelin sheath) of nerves of the brain, optic nerve, and spinal cord,” reports Codify.

The codes you’ll use in G36.- all go to the 4th character; here’s a look at the codes in the set, along with any alternate terms ICD-10 lists:

• G36.0 (Neuromyelitis optica [Devic])
  ♦ Demyelination in optic neuritis
• G36.1 (Acute and subacute hemorrhagic leukoencephalitis [Hurst])
• G36.8 (Other specified acute disseminated demyelination)
• G36.9 (Acute disseminated demyelination, unspecified)

Use G37.- for Other CNS Diseases

The last code set in the family is G37.- (Other demyelinating diseases of central nervous system), which you’ll use for other demyelinating CNS diseases. “Other demyelinating diseases of the central nervous system refer to neurological disorders that cause progressive damage to the covering (myelin sheath) of nerve fibers of the brain and spinal cord. The provider documents a type of demyelinating disease of the central nervous system not represented by any other code,” reports Codify.

The codes you’ll use in G37.- all go at least to the 4th character; here’s a look at the codes in the set, along with any alternate terms ICD-10 lists:

• G37.0 (Diffuse sclerosis of central nervous system)
  ♦ ​Periaxial encephalitis
  ♦ Schilder’s disease

• G37.1 (Central demyelination of corpus callosum)
• G37.2 (Central pontine myelinolysis)
• G37.3 (Acute transverse myelitis in demyelinating disease of central nervous system)
  ♦ Acute transverse myelitis NOS
  ♦ Acute transverse myelopathy

• G37.4 (Subacute necrotizing myelitis of central nervous system)
• G37.5 (Concentric sclerosis [Balo] of central nervous system)
• G37.81 (Myelin oligodendrocyte glycoprotein antibody disease)
  ♦ MOG antibody disease
• G37.89 (Other specified demyelinating diseases of central nervous system).
• G37.9 (Demyelinating disease of central nervous system, unspecified).