Neurosurgery Coding Alert

Question: What is the proper diagnosis code for cauda equina, and how does this condition differ from monoplegia?

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Answer: Patients suffering from cauda equina should be tagged with the G83.4 (Cauda equina syndrome) code.

Cauda equina syndrome refers to compression of the nerve roots in the lumbosacral region at the bottom of the spine (cauda equina) characterized by pain, numbness, and weakness in one or both legs; cauda equina syndrome is a rare disorder that requires urgent treatment to prevent permanent damage.

While cauda equina pertains to lower limbs only, patients can suffer from monoplegia in upper or lower limbs. Monoplegia refers to a neurological disorder caused by injury or disease of the spinal cord or nerves where the patient loses motor and sensory function in an extremity.

For patients suffering from monoplegia, you’ll choose from the following codes, depending on encounter specifics:

• G83.1- (Monoplegia of lower limb)
• G83.2- (Monoplegia of upper limb)
• G83.3- (Monoplegia, unspecified)

Other paralytic syndrome ICD-10s: In addition to cauda equina and monoplegia, ICD-10 also offers these codes in the G83.- (Other paralytic syndromes) set:

• G83.0 (Diplegia of upper limbs)
• G83.5 (Locked-in state)
• G83.81 (Brown-Sequard syndrome)
• G83.82 (Anterior cord syndrome)
• G83.83 (Posterior cord syndrome)
• G83.84 (Todd’s paralysis (postepileptic))
• G83.89 (Other specified paralytic syndromes)
• G83.9 (Paralytic syndrome, unspecified)

Proper use: in the notes for the G83.- code set, ICD-10 reports “This category is to be used only when the listed conditions are reported without further specification, or are stated to be old or longstanding but of unspecified cause. The category is also for use in multiple coding to identify these conditions resulting from any cause.”