Neurosurgery Coding Alert

Specify procedure causing the hematoma; count each level of pathology in the cervical spine.

It’s now time to mark the changes in ICD-10 for 2017. Here is a quick review of changes likely for nervous system conditions. Some codes for nervous system haemorrhage and hematoma will have a refinement in code descriptors. New specific codes will be added for hematoma. In mid-cervical pathologies, it will be important for you to look at the level involved.  

“The ICD-10 diagnostic coding system continues to undergo annual updates to provide more granularity,” says Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison.

Distinguish Postprocedure Haemorrhage and Hematoma in Nervous System

The anticipated ICD-10 changes will bring in specificity for postprocedure haemorrhage and hematoma of the nervous system. The descriptor of code G97.51 (Postprocedural hemorrhage and hematoma of a nervous system organ or structure following a nervous system procedure) will read ‘Postprocedural hemorrhage of a nervous system organ or structure following a nervous system procedure.’

Similarly, the descriptor of code G97.52 (Postprocedural hemorrhage and hematoma of a nervous system organ or structure following other procedure) will read ‘Postprocedural hemorrhage of a nervous system organ or structure following other procedure.’

New hematoma codes: You will see new codes for postprocedural hematoma of the nervous system. The following two new codes will be introduced:

• G97.61, Postprocedural hematoma of a nervous system organ or structure following a nervous system procedure
• G97.62, Postprocedural hematoma of a nervous system organ or structure following other procedure

“Bleeding (hemmorhage) can occur without a formation of a hematoma.  This distinguishes between the bleeding without accumulation of a blood clot (hematoma) from that with a blood clot,” Przybylski says.

Count Levels in Mid-Cervical Pathologies

When reporting mid-cervical pathologies in 2017, you will need to be absolutely specific about which spinal level is involved. Table 1 lists the codes that will be deleted and the new ones which will be introduced. These changes will apply to cervical myelopathy, radiculopathy, disc degeneration and displacement, and other disorders of the mid-cervical region.

What is new? You will have new codes for cervical disc disorders at C4-5, C5-6, and C6-7 levels. Additionally, there will be specific codes for situations when the level involved is not specified.