Neurology & Pain Management Coding Alert

Watch when you have fewer choices than with ICD-9.

Effective Oct. 1, 2015, a diagnosis of cerebral palsy will fall into one of four categories: spastic, ataxic, athetoid/dyskinetic, or mixed. ICD-10 will bring more type-specific diagnoses, so you’ll need to ensure that your physician documents the specific type of cerebral palsy in the clinical note.

Prepare For More Detailed Descriptors

One change that you will encounter in the ICD-10 codes for cerebral palsy is that the descriptors clearly specify “cerebral palsy.” Thus, cerebral palsy gains identity in the ICD-10 options.

When your physician documents spastic cerebral palsy affecting two limbs, you currently report ICD-9 code 343.0 (Congenital diplegia). The corresponding ICD-10 diagnosis is G80.1 (Spastic diplegic cerebral palsy).

Take note: ICD-10 code G80.1 clearly defines the spastic type of cerebral palsy. You cannot submit the same code for athetoid, mixed, or other types of cerebral palsies.

In ICD-9, the descriptors are not as specific. Other terms in the documentation that will help you to zero in for the ICD-9 codes for cerebral palsy include “spastic infantile paralysis,” “congenital cerebral spastic paralysis,” and “spastic paralysis due to birth injury.”

Watch for More Comprehensive Diagnoses

In some instances, ICD-9 gives you more diagnosis options for a condition than ICD-10 will. Such is the case with congenital hemiplegia and infantile hemiplegia.

Distinction: Congenital or infantile hemiplegia refers to brain injuries that occur before or at birth and lead to hemiplegia. The current and future diagnoses for these conditions are as follows:

Congenital hemiplegia – Report ICD-9 code 343.1 (Congenital hemiplegia), which corresponds to ICD-10 code G80.2 (Spastic hemiplegic cerebral palsy).

Infantile hemiplegia – If your physician documents the hemiplegia in a child aged less than 1 year in age, you turn to ICD-9 code 343.4 (Infantile hemiplegia). Instead of having a specific code for infants when using ICD-10, you’ll submit G80.2 as with congenital hemiplegia.

You will not need to confirm if the hemiplegia had an onset at birth or in the first year of life. This is because both the options in ICD-9, i.e. 343.1 and 343.4 map to a common ICD-10 code i.e. G80.2.

Broader descriptors also apply to hemiplegic and monoplegic palsies.

For spastic cerebral palsy that leads to quadriplegia, you now report ICD-9 code 343.2 (Congenital quadriplegia). This corresponds to ICD-10 code G80.0 (Spastic quadriplegic cerebral palsy). If the cerebral palsy affects only one limb, you report code 343.3 (Congenital monoplegia) in ICD-9. The corresponding ICD-10 code is G80.8 (Other cerebral palsy).

You do not have a very specific option for congenital monoplegia in ICD-10 as this is classified as ‘other cerebral palsy’ in ICD-10.

Don’t Miss the ‘Athetoid,’ ‘Ataxic’ and ‘Unspecified’ Choices

Athetoid cerebral palsy has a specific ICD-9 code, 333.71 (Athetoid cerebral palsy). The corresponding ICD-10 code will be a direct match: G80.3 (Athetoid cerebral palsy).

Note: Athetoid cerebral palsy is also called double athetosis. The condition involves symptoms on both sides of the body, whereas hemi-athetosis involves only one side. Double athetoisis is included under ICD-10 diagnosis G80.3.

For any other specific type of cerebral palsy that your physician reports, you can submit ICD-9 code 343.8 (Other specified infantile cerebral palsy). ICD-10 will have two corresponding codes:

• G80.8 – Other cerebral palsy
• G80.4 – Ataxic cerebral palsy.

Thus, ICD-10 will include a specific code for ataxic cerebral palsy.

Sometimes, however, your physician might not specify the type of cerebral palsy in his documentation. In this situation you currently submit 343.9 (Infantile cerebral palsy, unspecified), which maps to G80.9 (Cerebral palsy, unspecified) in ICD-10.