Neurosurgery Coding Alert

Do you know what secondary parkinsonism is?

When most coders think of movement disorders, Parkinson’s disease often leaps to the front of the mind.

It’s no surprise; Parkinson’s is perhaps to most common movement disorder. But did you know that ICD-10 has an entire code set dedicated to “Extrapyramidal and movement disorders (G20-G26)”?

To get a handle on the code set as a whole, we asked Beth Schleeper, COC, CPC, CPCO, CDEO, CPB, CPMA, CPPM, CRC, CPC-I, CEMC, CANPC, CEMA, owner/ instructor of Advanced Coding Services in Phoenix, for some pointers on finding the right diagnosis code for each movement disorder.

Know Parkinson’s, Secondary Parkinsonism

At the forefront of the movement disorder sequence is G20 (Parkinson’s disease). Use this for all patients suffering from Parkinson’s disease, as well as:

• Hemiparkinsonism
• Idiopathic Parkinsonism or Parkinson’s disease
• Paralysis agitans
• Parkinsonism or Parkinson’s disease NOS
• Primary parkinsonism or Parkinson’s disease

You’ll also need to know how to code secondary parkinsonism, which you’d report with G21.0 (Malignant neuroleptic syndrome) through G21.9 (Secondary parkinsonism, unspecified), depending on encounter specifics.

According to Medline, National Library of Medicine, “secondary parkinsonism is when symptoms similar to Parkinson disease are caused by certain medicines, a different nervous system disorder, or another illness.

“Parkinsonism refers to any condition that involves the types of movement problems seen in Parkinson disease. These problems include tremors, slow movement, and stiffness of the arms and legs.”

Also: You will need to select another ICD-10 code“if there is an adverse effect, to identify the drug,” Schleeper says. Each of the secondary parkinsonism codes has its own “Use additional code” instruction, printed in red under the code listing.

Use G24 Code Set for Dystonia

Another movement disorder that is well-represented in G20-G26 is dystonia, which you’ll report with codes from G24.0 (Drug induced dystonia) through G24.9 (Dystonia, unspecified).

“Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements,” according to the Mayo Clinic.

Get Familiar With Other Dx Groups in G20-G26

While the aforementioned diagnoses get most of the attention in the extrapyramidal and movement disorders code set, there are a few more codes out there that round out G20-G26. Check out this rundown of those other codes:

Other degenerative diseases of basal ganglia: Codes G23.0 (Hallervorden-Spatz disease) through G23.9 (Degenerative disease of basal ganglia, unspecified).

Other extrapyramidal and movement disorders: Codes G25.0 (Essential tremor) through G25.9 (Extrapyramidal and movement disorder, unspecified).

Extrapyramidal and movement disorders in diseases classified elsewhere: Code G26 (Extrapyramidal and movement disorders in diseases classified elsewhere).