Radiology Coding Alert

Question: Our interventional radiologist saw a patient with a sacral Tarlov cyst. Which ICD-9 codes should I report for the cyst? Florida Subscriber Answer: For the diagnosis code, the ICD-9 alphabetic index directs coders to review 355.9 (Mononeuritis of unspecified site). You also may want to review 349.2 (Disorders of meninges, not elsewhere classified) with your radiologist, as this code is appropriate for spinal meninges cysts. The diagnosis: Tarlov cysts are cerebrospinal fluid (CSF) filled sacs typically located at the S1, S2, and S3 level of the sacrum. These cysts (also known as meningeal or perineural cysts) can compress nerve roots, causing lower back pain (724.2), sciatica (724.3), urinary incontinence (788.30), headaches (784.0), constipation (564.00), sexual dysfunction (302.70), and numbness in the leg and/or foot (782.0). Tarlov cysts often are diagnosed using magnetic resonance imaging.