Neurology & Pain Management Coding Alert

Question: Which ICD-9 code should I report for neck-tongue syndrome?

Georgia Subscriber

Answer: The most appropriate ICD-9 code for neck-tongue syndrome is 352.5 (Disorders of hypoglossal [12th] nerve).

Definition: Neck-tongue syndrome is a fairly uncommon headache disorder that consists of pain in the neck and altered sensation in half of the tongue aggravated by neck movement. This condition is attributed to damage to nerve fibers travelling in the hypoglossal nerve that passes under the tongue to the spinal roots. Neck-tongue syndrome usually occurs during sudden head rotation and affects the side of the tongue that corresponds to the direction the patient's head is turning in, creating compression of the hypoglossal.

Track it down: Start off in the ICD-9 index at "Compression." If you go to the subheading "nerve NEC," you notice that it directs you to "see also Disorder, nerve." Under this heading you-ll find "hypoglossal 352.5."

-- Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh.