Neurology & Pain Management Coding Alert

Don’t forget to include an E code when necessary.

Spasmodic torticollis (ST) – also known as cervical dystonia – is a neurological condition thought to be caused by a disturbance in the balance of chemicals produced in the brain. Increased nerve signals cause intermittent or sustained neck muscle contractions. These involuntary spasms cause the patient’s head to lean to one side or be pulled forward or backward. ST is usually accompanied by constant and extreme pain.

ICD-9 choice: You currently have a single diagnosis code for spasmodic torticollis, 333.83 (Spasmodic torticollis). If the provider doesn’t document a specific type of torticollis, you report 723.5 (Torticollis, unspecified).

If the physician documents cervical dystonia, you’ll still find yourself choosing a diagnosis from the same code family (333.6-333.89).

ICD-10 option: When ICD-10 goes into effect in October, you’ll have a simple diagnosis shift for spasmodic torticollis. Code 333.83 makes a straight crossover to G24.3, with the same descriptor that’s currently in place.

Coding tip: If your physician determines that the patient’s spasmodic torticollis is drug induced, also report the applicable E code to identify the drug.