Neurosurgery Coding Alert

Question: Our physician documented a diagnosis of neoplasm in the spinal accessory nerve. What is the most appropriate ICD-10-CM code that we can submit for this diagnosis?

Alaska Subscriber

Answer: You do not have a definitive code for neoplasms in the spinal accessory nerves. For a malignant neoplasm originating in the spinal accessory nerve, you submit code C72.59 (Malignant neoplasm of other cranial nerves). In the rare events of a secondary neoplasm in this nerve, you submit code C79.49 (Secondary malignant neoplasm of other parts of nervous system). However, a secondary malignant neoplasm of a cranial nerve would be exceedingly unusual. More commonly, a cranial nerve neoplasm is benign and would be reported with ICD-10 D33.3 (Benign neoplasm of cranial nerves). If the histopathology of the cranial nerve is uncertain, one would report ICD-10 D43.3 I (Neoplasm of uncertain behaviour of cranial nerves).

You may make a note that code C72.59 is a code for cranial nerves. The spinal accessory nerve is actually the spinal part of the XIth cranial nerve that supplies muscles in the neck.