Radiology Coding Alert
Assess Your Understanding Of Neck Pain Diagnosis In ICD-10
ICD-10 offers more definitive codes for cervical spondylosis, stenosis, subluxation, and somatic dysfunction.
In the last issue of Radiology Coding Alert, you attempted a quiz on conditions that can cause neck pain. Here are answers to the questions for the quiz.
Tip: When reporting pain the neck, bear in mind that not all conditions may have a direct match. Also, check out how ICD-10 gets more specific.
Answer 1: The correct answer is b, M99.01.
ICD-9: The ICD-9 CM code for segmental and somatic dysfunction is 739.1(Nonallopathic lesions of cervical region not elsewhere classified).
ICD-10: The best match for 739.1 is ICD-10 code M99.01 (Segmental and somatic dysfunction of cervical region).
Remember: In ICD-10, the category M99 (Biomechanical lesions, not elsewhere classified) splits into ten possibilities, M99.00-M99.14. These include the following for the head and spine:
Answer 2: The correct answer is a, M99.11.
ICD-9: Suppose you have to report code 839.0 (Closed dislocation cervical vertebra), listed within category 839 (Other multiple and ill-defined dislocations). Code 839.0 includes “displacement, subluxation” and excludes “congenital, pathological or recurrent dislocations.”
ICD-10: In ICD-10 the best match is M99.11 (Subluxation complex [vertebral] of cervical region).
Category M99 (Biomechanical lesions, not elsewhere classified) gives you ten possibilities based on the location of the disorder, M99.00-M99.14. These include the following for the head and spine:
What is new in ICD-10: The ICD-10 codes represent greater details and specificity. The digit after the decimal point represents the subcategory code describing the site, etiology, manifestation, or state of the disease or condition.
Answer 3: The correct answer is c, S13.4xx_.
ICD-9: In ICD-9, neck sprain and strain have a common code: 847.0 (Neck sprain) under category 847 (Sprains and strains of other and unspecified parts of back).
ICD-10: You will code for neck sprain using S13 (Dislocation and sprain of joints and ligaments at neck level). This code includes:
You’ll also have codes further on for other parts of the cervical regions such as:
Answer 4: The correct answer is d, S16.1.
ICD-9: In ICD-9, neck sprain and strain have a common code: 847.0 (Neck sprain) under category 847 (Sprains and strains of other and unspecified parts of back).
ICD-10: In ICD-10, you will have a specific code, S16.1 (Strain of muscle, fascia and tendon at neck level), for neck strain.
Answer 5: The best option is c, M67.88 or M48.8X2.
When you are reporting ossification of posterior longitudinal ligament in the cervical region, the initial code that you find may not be the best crossover.
ICD-9: For ossification of posterior longitudinal ligament in the cervical region, you currently report code 723.7 (Ossification of posterior longitudinal ligament in cervical region).
ICD-10: The code 723.7 maps to code M67.88 (Other specified disorders of synovium and tendon, other site) in ICD-10 databases. However, a more appropriate ICD-10 code may be M48.8X2 (Other specified spondylopathies, cervical region), depending on the individual case.
Answer 6: The correct answer is b, M48.02.
ICD-9: For cervical spinal stenosis, you report ICD-9 code 723.0 (Spinal stenosis in cervical region).
ICD-10: The ICD-9 code 723.0 maps to codes M48.01 (Spinal stenosis, occipito-atlanto-axial region) - M99.71 (Connective tissue and disc stenosis of intervertebral foramina of cervical region) in ICD-10.
For the diagnosis of stenosis in cervical region of the spine, you submit code M48.02 (Spinal stenosis, cervical region).
However, there are other specific codes depending upon the precise location of the stenosis in the cervical region. For spinal stenosis in the cervical region close to the junction with the skull, you submit code M48.01 (Spinal stenosis, occipito-atlanto-axial region) and for that in the region close to the thoracic region, i.e. lower down the cervical spine, you submit code M48.03 (Spinal stenosis, cervicothoracic region).
The ICD-10 diagnosis coding also offers you the following two codes for subluxation stenosis of the neural canal in head and neck:
For osseous stenosis of head and neck region, you have codes M99.30 (Osseous stenosis of neural canal of head region) and M99.31 (Osseous stenosis of neural canal of cervical region).
When your physician documents stenosis in the connective tissues of the neural canal in the head or neck region, you report code M99.40 (Connective tissue stenosis of neural canal of head region) and M99.41 (Connective tissue stenosis of neural canal of cervical region), respectively. For stenosis of intervertebral disc in the head and cervical region, you turn to codes M99.50 (Intervertebral disc stenosis of neural canal of head region) and M99.51 (Intervertebral disc stenosis of neural canal of cervical region), respectively.
Answer 7: The correct answer is b, M47.12.
For cervical spondylosis with myelopathy, you submit the ICD-9 code 721.1 (Cervical spondylosis with myelopathy).
ICD-10: In ICD-10, code721.1 maps to the following three codes for cervical spondylosis and myelopathy:
ICD-10 offers more specific choices for cervical spondylosis with myelopathy. You select the right code based upon the location of the disorder in the cervical spine, i.e. the occipital-atlanto-axial, cervical, and cervicothoracic region. The best code in the scenario described in this question is M47.12.
Answer 8: The correct answer is d, M47.015.
Anatomical location guides your coding for anterior spinal artery compression syndrome. ICD-10 offers the following choice for this syndrome:
Similarly, for vertebral artery compression syndrome, you have the following 3 codes to choose from:
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