Neurosurgery Coding Alert

Reader questions:

353.0 or 344.9 = long thoracic nerve palsy diagnosis

Question: What is the best diagnosis code for long thoracic nerve palsy? Oregon Subscriber Answer: You have two possibilities: 353.0 (Nerve root and plexus disorders; brachial plexus lesions) or 344.9 (Paralysis, unspecified). The long thoracic nerve is part of the brachial plexus. When you check "Palsy" in ICD-9, the index directs you to also check "Paralysis." The diagnosis for brachial plexus paralysis is 353.0. Another option: If 353.0 doesn't match your physician's documentation or the patient's signs and symptoms, your alternative diagnosis would be 344.9 (Paralysis, unspecified).
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