Neurology & Pain Management Coding Alert

Reader Question:

Spinal CSF Leak May Be Nonspecific

Published on Wed May 23, 2012

Question: Which code in ICD-9 can we report for CSF leakage from the lumbar spine? It is not from a complication or injury. Please advise.

North Carolina Subscriber

Answer: A CSF (cerebrospinal fluid) leak is when the fluid around the brain and spine leaks out somewhere. This can occur due to head trauma, after surgeries around the brain/sinuses/ear/skull or from procedures that cause an opening into the spinal fluid, e.g., spinal tap (lumbar puncture). CSF leaks that occur idiopathically are referred to as Spontaneous cerebrospinal fluid leak syndrome (SCSFLS). The principal symptom of Spontaneous CSF leaks is headaches.

ICD-9 includes only limited options for reporting this condition. Unless the physician documents specific symptoms, your best option would to review 349.9 (Unspecified disorders of nervous system), 349.39 (Other dural tear) or 349.89 (Other specified disorders of nervous system.) You may choose more specific codes depending upon the symptoms, if any are documented.

ICD-10 does provide more specificity with G96.0 (Cerebrospinal fluid leak).

Neurology & Pain Management Coding Alert

6 Tips Help You Sidestep Spinal Puncture Denials
Intent and modifiers help to recoup your payment.
Although apparently simple, the codes [...]

ICD-10 Update:
Tactics Take the Ache Out of Your Migraine Diagnosis Reporting
Key: Severity and chronicity take you to the right code.When reporting migraine, your best approach [...]

Precise Definition of Status Migrainosus
The International Society for Headache describes Status Migrainosus as a "debilitating migraine attack lasting for [...]

What Is Aura?
"Aura" is a term that describes the complex neurological symptoms that precede an attack of [...]

Pain Management:
Follow 4 Strategies to Post-op Pain Management Coding Success
Hint: Stay away from reporting one service, even with thorough documentation.When your pain management specialist [...]

You Be the Coder:
Submitting Lab Tests With MILD Procedure
Question: Our physician sometimes performs a MILD procedure at the hospital and sends the patients [...]

Reader Question:
Avoid Modifiers to Report EMG with Nerve Conduction
Question: We have received a denial for codes 95860 (Needle electromyography; 1 extremity with or [...]

Reader Question:
Spinal CSF Leak May Be Nonspecific
Question: Which code in ICD-9 can we report for CSF leakage from the lumbar spine? [...]

Reader Question:
Report Cerebellar Gangliocytoma as Benign Tumor
Question: How do we report Lhermitte-Duclos in ICD-9?Alaska SubscriberAnswer: You may report code 215.0 (Other [...]

Reader Question:
Bill Blood Collection for Laboratory Testing
Question: One of our nurses asked if we can bill the insurance companies for a [...]

Reader Question:
Turn To Level, Not Session for 72285 and 72295
Question: The descriptors for codes 62290 and 62291 specify "each level." Should we report related [...]

View All