Ch 9 nervous System

Ch 9 Nervous System

Watch for combination codes, there are a lot in this section!

LOTS of "use additional code" notes in the tabular

Guidelines

We rarely know,
if unspecified:
right hand defaults as dominant
left side defaults as non-dominant
ambidextrous patient = dominant

Dominant v. nondominant

Affected sides

Admission is for treatment of pain

Admission is for insertion of neurostimulator for pain control

​G89 first listed when...

Can be used to add acute/chronic, cancer pain, etc. IF THE DOCUMENTATION SAYS SO

Do not use if definitive dx is known unless reason for admission is pain management

G89 Pain NOS

Pain

​Use with
location codes
if necessary

Sequencing

-Admit for pain control- G89 first
-Admit for other reason, but we dont know definitive dx, only pain location and type, then code pain location first (ex: laparoscopy for chronic abdominal pain)
- Pain due to medical devices is coded elsewhere as a complication

Post op pain

Routine/expected - should not be coded
- G89 if its post op pain with no complication
- Post op pain with complication (painful wire sutures) gets a complication code, and then a G89 code

Neoplasm related pain G89.3 is used for cancer or tumor pain regardless of if the pain is acute or chronic

Dont forget the sequencing guidelines we went over in our Neoplasm chapter (its listed here too, for convenience)

Neoplasm Pain

Chronic pain is not the same as CPS (Chronic Pain Syndrome)

Chronic has no timeframe, rely on provider documentation

​Chronic

Other pains

A specific disease
Can be with or without dementia

This is a G code, with an F code added if applicable

​Alzhiemers

a variety of symptoms such as loss of recent memories, language issues, deficient ADL abilities, personality changes,
loss of problem solving processes, visual delusions
This is an F code with a G code first if applicable

Dementia

Alzhiemers and Dementia

Seizures, Epilepsy, Convulsions

Do not use the terms interchangeably

A single seizure event is a convulsion - R code
A seizure disorder, or recurrent seizures is Epilepsy - G code

Be careful with recurrent febrile seizures, this would still be an R code because the fever is causing the seizures and not a epileptic change in brain electricity

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Chronic lumbosacral back pain

.

,

.

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Recurrent Seizures

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Take out your PCS manual

Get ready to rumble

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Diagnostic lumbar spinal puncture

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Cerebral ventricular-peritoneal shunt (VP Shunt) using synthetic shunt material for shunt creation via open technique