Neurosurgery Coding Alert
Nail Down the Cause of Ventriculomegaly Ex Vacuo
Question: My doctor documented that a patient has moderate ventriculomegaly, which is -ex vacuo in nature due to her age-appropriate atrophy.- Is 331.9 the correct diagnosis code to use?
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Answer: Ventriculomegaly ex vacuo (or hydrocephalus ex vacuo) is the enlargement of the ventricles because of shrinkage of the brain. If your neurosurgeon detects the enlargement but determines that it is the result of normal atrophy that occurs with age, you should use the ICD-9 code for nonspecific signs and symptoms (793.0, Nonspecific abnormal findings on radiological and other examination of body structure; skull and head).
Ventriculomegaly ex vacuo can also be the result of degenerative brain disease, such as Pick's disease (331.11) or Alzheimer's (331.0), or can be related to unspecified abnormal cerebral degeneration (331.9). Be sure to report the most accurate diagnosis code your physician indicates.
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