Neurology & Pain Management Coding Alert

Question: The physician documented that following a diagnostic spinal tap, the patient had a headache attributed to lowcerebrospinal fluid pressure. What diagnosis code do we select?

Wyoming Subscriber

Answer: The best choice from ICD-9 is 349.0 (Reaction to spinal or lumbar puncture); the descriptor includes the notation of "Headache following lumbar puncture," which could be the situation for the patient in question.

ICD-10: Although many code descriptors will undergo many changes when ICD-10 becomes effective in October 2013, diagnosis 349.0 will remain virtually the same. The new ICD-10 code will be G97.1 (Other reaction to spinal and lumbar puncture). The accompanying notation of included conditions still states, "Headache due to lumbar puncture."