Neurology & Pain Management Coding Alert

ICD-10 will keep many familiar descriptors the same.

As mentioned in “Know the Top Areas the OIG Is Watching On Your Polysomnography Claims,” many diagnoses can support the need for polysomnography. Fortunately for coders, many of your most familiar diagnoses won’t undergo extensive changes when ICD-10 becomes effective in October.

Comparison: See below for how five common diagnoses will change for ICD-10.

In ICD-10, the chapter of G codes represents “Diseases of the nervous system.” Codes from G47 are found in the category “Sleep disorders” under the larger block section “G40-G47 Episodic and paroxysmal disorders.”

The chapter of F codes is for “Mental, Behavioral and Neurodevelopmental Disorders.” The specific category header for the F51 section is “Sleep disorders not due to a substance or known physiological condition,” under the larger block section head of “F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors.”

Notice that the shift from 780.51 to G47.30 represents a not-so-common change with ICD-10: the original descriptor is more detailed than its ICD-10 version. ICD-9 specifies that the sleep apnea is in conjunction with insomnia, but the updated code doesn’t. However, the code location in ICD-10 is more specific. The diagnoses shift from being part of the signs/symptoms chapter in ICD-9 to more appropriate locations in ICD-10.

Explanation: Signs and symptoms that point to a specific diagnosis are assigned to an ICD-10 category in other chapters of the classification. For example, the sleep disturbances diagnoses will move from the ICD-9 chapter focusing on “Symptoms, Signs and Ill-Defined Conditions” to Chapter 6, “Diseases of the Nervous System” in ICD-10.