Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that a patient suffers from “frontal lobe synd.” What diagnosis code should I report for this patient?

Idaho Subscriber

Answer: You will need a pair of ICD-10 codes for this patient. Based on the information provided, you can select one of the diagnosis codes. The code for frontal lobe syndrome is F07.0 (Personality change due to known physiological condition). You should also use this code if the encounter notes indicate a patient suffers from any one of the following:

• Limbic epilepsy personality syndrome
• Lobotomy syndrome
• Organic personality disorder
• Organic pseudopsychopathic personality
• Organic pseudoretarded personality
• Postleucotomy syndrome

The catch: F07.0 is a secondary code; you cannot list it as a primary diagnosis, and ICD-10 tells you so directly under the descriptor for F07.- (Personality and behavioral disorders due to known physiological condition): “Code first the underlying physiological condition.”

Do this: Go back and see what the patient’s underlying physiological condition, and code that first. For example, if the patient suffers from frontal lobe syndrome due to a cerebral infarction (CI), you’d choose a code from the I63.- (Cerebral infarction) code set as the primary diagnosis.