Neurology & Pain Management Coding Alert

Question: My neurologists give me information on many co-existing conditions (cardiology, oncology, orthopedic, etc.) to code in addition to the patients- neurological conditions. Should I include these on our claim forms if the co-existing conditions are not causing or impacting the primary neurological condition?

Maryland Subscriber

Answer: You are correct in thinking that a secondary diagnosis may be reported only when the condition is a consideration within your neurologist's medical decision-making.

Being a -consideration- does not mean your physician is treating the secondary condition. However, if the condition has an impact on your physician's consideration for neurological treatment, you may report the underlying conditions.

Tip: If your patients often have co-existing conditions, add some of them to your neurologist's check sheet. These might include diabetes, diabetic neuropathy, some pain codes, hyperlipidemia or others. Also leave a few blank spaces on the form for a narrative so your physician can document anything that is not on the form.

More info: See Sections IV.H and IV.K of the ICD-9-CM Official Guidelines for Coding and Reporting for guidance regarding the reporting of co-existing conditions.