Medical Coding for Top Six Neurological Conditions

by | Posted: Aug 3, 2022 | Medical Coding

According the World Health Organization (WHO), neurological disorders affect millions of people around the world -which include around 24 million individuals suffering from Alzheimer’s disease and 326 million individuals suffering from migraine. There are several factors that cause neurological disorders and these include -genetic defects, degenerative changes, seizure disorders, vascular problems, injuries, structural or anatomic defects and other infections. The symptoms of neurological disorders can vary significantly -depending on the type of disorder and the specific body part that gets affected. When it comes to reporting symptoms and diagnoses of different neurology conditions on their medical claims, physicians can depend on reliable medical billing and coding companies. Such companies will have skilled medical coding service providers who are familiar with the codes and other related guidelines, and can easily manage the coding and claim submission processes.

Below listed are the top six neurological conditions and their related ICD-10 codes –

Parkinson’s disease (PD) -PD is a chronic, progressive disorder that affects the nervous system and the parts of the body controlled by the nerves. The condition causes progressive deterioration of motor function due to loss of dopamine-producing brain cells. The exact cause of this condition is unknown. However, a combination of factors like genetics, age, exposure to toxins, and environmental triggers tend to increase the risk of this condition in the long run. Symptoms begin gradually and worsen over time. The initial symptoms of PD may vary from one person to another and may often be mild and go unnoticed. It develops gradually, (beginning with a barely noticeable tremor in just one hand) and can also cause stiffness or slowing of movement. Other related symptoms include -lowed movement, rigid muscles, speech changes, impaired posture and balance, loss of automatic movements and writing changes. There is no specific test to diagnose PD. However, diagnosis involves a medical history review, evaluation of symptoms and a detailed physical and neurological examination. Imaging tests like – single-photon emission computerized tomography (SPECT) scan, MRI, ultrasound of the brain and PET scans may be performed to confirm the diagnosis and initiate treatment. Treatment involves a combination of medications to control the symptoms.

ICD-10 Diagnosis Codes for PD

G20 Parkinson’s disease

  • G21 Secondary parkinsonism
    • G21.0 Malignant neuroleptic syndrome
  • G21.1 Other drug-induced secondary parkinsonism
    • G21.11 Neuroleptic induced parkinsonism
    • G21.19 Other drug induced secondary parkinsonism
    • G21.2 Secondary parkinsonism due to other external agents
    • G21.3 Postencephalitic parkinsonism
    • G21.4 Vascular parkinsonism
    • G21.8 Other secondary parkinsonism
    • G21.9 Secondary parkinsonism, unspecified

Headaches -This is a common neurological disorder that can affect people of all age groups. Headaches result from signals interacting among the brain, blood vessels and surrounding nerves. There are different types of headaches that fall into different categories and caused by various factors like medication use, tension and stress, sleep disruption, head injury or tumor, sinus and more. If untreated, this condition can cause weakness, dizziness, sudden loss of balance or falling, numbness or tingling and even paralysis. Diagnosis of headaches will involve a physical examination, medical history evaluation and a detailed neurological examination wherein the symptoms that may be causing the condition can be evaluated. Treatment for headaches involves medications and key lifestyle changes. ICD-10 codes include-

  • R51 Headache
    • R51.0 Headache with orthostatic component, not elsewhere classified
    • R51.9 Headache, unspecified

Epilepsy and Seizures -A common neurological disorder, epilepsy occurs when the brain activity becomes abnormal. The condition causes seizures or periods of unusual behavior, sensations and sometimes loss of awareness. It affects both males and females of all age groups. This neurological disorder can develop from brain injury, stroke, brain cancer, and drug or alcohol abuse. The signs and symptoms may vary depending on the type of seizure and may include – uncontrollable jerking movements of the arms and legs, loss of consciousness or awareness, temporary confusion, a staring spell and psychic symptoms such as fear and anxiety.

Diagnosis of epilepsy involves neurological exams, blood tests and other tests to detect brain abnormalities. Imaging tests such as Electroencephalogram (EEG), computerized tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET), single-photon emission computerized tomography (SPECT), neuropsychological tests and certain analysis techniques to help identify the origin of the brain seizures. Initial treatment of epilepsy involves medications. If medications fail to control seizures, physicians will propose surgery or other types of treatment like – vagus nerve stimulation, ketogenic diet, and deep brain stimulation. ICD-10 codes for epilepsy include-

  • G40 Epilepsy and recurrent seizures
    • G40.0 Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset
    • G40.1 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures
    • G40.2 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures
    • G40.3 Generalized idiopathic epilepsy and epileptic syndromes
  • G40.A Absence epileptic syndrome
    • G40.A0 Absence epileptic syndrome, not intractable
    • G40.A1 Absence epileptic syndrome, intractable
  • G40.B Juvenile myoclonic epilepsy [impulsive petit mal]
    • G40.B0 Juvenile myoclonic epilepsy, not intractable
    • G40.B1 Juvenile myoclonic epilepsy, intractable
    • G40.4 Other generalized epilepsy and epileptic syndromes
    • G40.5 Epileptic seizures related to external causes
    • G40.8 Other epilepsy and recurrent seizures
    • G40.9 Epilepsy, unspecified

Stroke -According to the Centers for Disease Control and Prevention (CDC), stroke is a leading cause of death in the United States. It is estimated that more than 795,000 people in the US people suffer a stroke every year. Stroke occurs when any specific blood vessel in the brain ruptures and bleeds, causing a blockage in the blood supply to the brain. The rupture or blockage prevents blood and oxygen from reaching the brain’s tissues. Signs and symptoms of stroke include -paralysis, slurred speech, loss of balance or coordination, numbness or weakness (on one side of the body), sudden behavioral changes, seizures and nausea or vomiting. Diagnosis of stroke involves blood tests and other imaging tests (like – MRI scan, CT scan, electrocardiogram (EKG), Cerebral angiogram, Carotid ultrasound and Echocardiogram. Treatment for this condition involves a combination of medications and surgery (in severe cases – to remove blood clot). ICD-10 diagnosis codes for stroke include-

  • I60 -Nontraumatic subarachnoid hemorrhage
    • I61 -Nontraumatic intracerebral hemorrhage
    • I62 -Other and unspecified nontraumatic intracranial hemorrhage
    • I63 -Cerebral infarction
    • I65 -Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction
    • I66 -Occlusion and stenosis of cerebral arteries, not resulting in cerebral infarction
    • I67 -Other cerebrovascular diseases
    • I68 -Cerebrovascular disorders in diseases classified elsewhere
    • I69 -Sequelae of cerebrovascular disease

Amyotrophic Lateral Sclerosis (ALS) -Regarded as a progressive, neurological disease, ALS causes dysfunction in the nerve cells in the brain and spinal cord that control muscle movement. Often, ALS begins with muscle twitching and weakness in a limb, or slurred speech. Eventually, the condition affects control of the muscles required to move, speak, eat and breathe. The exact factors that cause the condition are not fully known. However, several environmental and genetic factors tend to play a prominent role. Signs and symptoms associated with the condition may differ from person to person, depending on the specific neurons that get affected. Common symptoms include -difficulty walking or doing normal daily activities, hand weakness, tripping and falling, slurred speech, weakness in the legs, feet or ankles, muscle cramps and twitching in the arms, shoulders and tongue and cognitive and behavioral changes. As the symptoms of this condition mimic that of other neurological diseases, diagnosis of ALS is often difficult. However, a combination of tests like – Electromyogram (EMG), blood and urine tests, nerve conduction studies, MRI and muscle biopsy could help arrive at a correct diagnosis. Treatment modalities include medications and other alternative therapies. ICD-10 codes for ALS include-

  • G12.21 Amyotrophic lateral sclerosis

Alzheimer’s Disease (AD) -Alzheimer’s disease is a progressive brain disorder that causes the brain cells to shrink and degenerate. One of the most common causes of dementia, the condition results in a continuous decline in the thinking, behavioral and social skills that affects a person’s ability to function independently. Forgetting recent events or conversations include the early signs and symptoms of the condition. However, as the condition progresses and increases its severity several other symptoms like – difficulty remembering things and organizing thoughts and forgetting recent events or conversations tend to develop. Diagnosis of AD involves a series of physical and neurological examinations. There is no specific treatment that completely cures AD. Medications may temporarily improve symptoms or slow the rate of decline. ICD-10 codes for AD include-

  • G30 Alzheimer’s disease
    • G30.0 Alzheimer’s disease with early onset
    • G30.1 Alzheimer’s disease with late onset
    • G30.8 Other Alzheimer’s disease
    • G30.9 Alzheimer’s disease, unspecified

For precise and timely billing and claims submission, healthcare practices can outsource their billing and coding tasks to a reputable neurology medical billing company that provides the services of AAPC-certified coding specialists.

Rajeev Rajagopal

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