Neurosurgery Coding Alert

Question: Can you explain which ICD-10 codes we would go to when reporting nonruptured and congenital cerebral aneurysms?

Minnesota Subscriber

Answer: If the nonruptured cerebral aneurysm is located in the intracranial portions of the internal carotid artery, then you would report I67.1 (Cerebral aneurysm, nonruptured).

According to ICD-10, conditions included under I67.1 are: cerebral aneurysm NOS; cerebral arteriovenous fistula, acquired; internal carotid artery aneurysm, intracranial portion; and internal carotid artery aneurysm, NOS.

If the aneurysm is located in the other extracranial segments of the carotid artery, like the common carotid artery, external carotid artery, or extracranial portion of the internal carotid artery, then you would report I72.0 (Aneurysm of carotid artery).

According to ICD-10, conditions included under I72.0 are: aneurysm of the common carotid artery; aneurysm of the external carotid artery; and aneurysm of internal carotid artery, extracranial portion.

Don’t miss: Make sure the neurosurgeon clearly documents the anatomical location of the aneurysm in the internal carotid artery. When the surgeon does not document the location specifically, you should report I67.1.

For congenital aneurysms in the cerebral circulation, you should report the following codes:

• Q28.2 (Arteriovenous malformation of cerebral vessels). This code includes the conditions arteriovenous malfor­mation of brain NOS and congenital arteriovenous cerebral aneurysm (nonruptured)
• Q28.3 (Other malformations of cerebral vessels). This includes congenital cerebral aneurysm (nonruptured); congenital malformation of cerebral vessels NOS; and developmental venous anomaly.

Coding tip: When reporting ICD-10 codes for congenital aneurysms, you will need your surgeon to confirm the cause for the aneurysm. When the aneurysm is associated with an arteriovenous malformation, you will report Q28.2.

For any other underlying cause, for example, aneurysms associated with congenital collagen disorders or other genetic syndromes, you will report ICD-10 code Q28.3.