Neurosurgery Coding Alert

Beware: Not all ICD-9 codes have a one-to-one match.

Reporting benign neoplasms of the central nervous system (CNS) aren’t a challenge. ICD-10 will offer you some direct code matches. In other situations, you will have multiple specific yet simple codes. Follow these three important tips to ensure you get your deserved payment for benign neoplasm of the CNS.

Specify Location for Benign Neoplasms of Brain

When your physician makes a diagnosis of benign neoplasm of the brain, you submit ICD-9 code 225.0 (Benign neoplasm of brain).

ICD-10 codes: When ICD-10 is implemented in October this year, you will submit codes D33.0 (Benign neoplasm of brain, supratentorial) or D33.1 (Benign neoplasm of brain, infratentorial), depending upon whether the tumor was located above or below the tentorium in the brain. However, when your surgeon does not specify the location of these tumors, you submit ICD-10 code D33.2 (Benign neoplasm of brain, unspecified). 

“The new diagnostic codes follow the pattern of procedure codes which specify the site of tumor based on supratentorial and infratentorial location,” says Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center, Edison.

Identify Discrete Code for Cerebral Meninges

When your physician documents a diagnosis of benign neoplasm of the cerebral meninges you submit ICD-9 code 225.2 (Benign neoplasm of cerebral meninges). 

How is ICD-10 different? When ICD-10 is implemented, you will distinguish tumors of meninges of the cerebrum from those in meninges over other structures of the brain. You have a discrete code for benign tumor of the cerebral meninges, i.e. D32.0 (Benign neoplasm of cerebral meninges). You submit code D32.9 (Benign neoplasm of meninges, unspecified) when your physician does not specify the site of the benign meningeal tumor.  “While the unspecified code might be applied for a craniocervical junction meningioma that involves both cerebral and spinal meninges, it is always best to report the most specific diagnostic code when possible,” Przybylski says.

Look For a Direct Match for Some Key Tumors

ICD-10 offers you a direct one-to-one match for benign neoplasm of the cranial nerves. 

The ICD-9 code 225.1 (Benign neoplasm of cranial nerves) maps to ICD-10 code D33.3 (Benign neoplasm of cranial nerves).

Similarly, you have direct code matches for benign tumors of the spinal cord, including those in the cauda equine and the benign tumors of the spinal meninges. The ICD-9 code 225.3 (Benign neoplasm of spinal cord) for benign tumor of the spinal cord maps to ICD-10 code D33.4 (Benign neoplasm of spinal cord). For benign tumors of the spinal meninges, you submit ICD-9 code 225.4 (Benign neoplasm of spinal meninges), which maps to ICD-10 code D32.1 (Benign neoplasm of spinal meninges).

For benign tumors elsewhere in the brain, you submit ICD-9 code 225.8 (Benign neoplasm of other specified sites of nervous system). When your physician does not document the site of the benign tumor in the brain, you submit ICD-9 code 225.9 (Benign neoplasm of nervous system part unspecified). These codes map to codes D33.7 (Benign neoplasm of other specified parts of central nervous system) and D33.9 (Benign neoplasm of central nervous system, unspecified), respectively in ICD-10.