foraminal narrowing?

[BFAITHFUL]

what dx code should I use for C3-C4 foraminal narrowing? thank you!

[RebeccaWoodward*]

Originally Posted by BFAITHFUL

what dx code should I use for C3-C4 foraminal narrowing? thank you!

Could 723.0 work with the documentation since stenosis is a narrowing of the spinal canal?

[gost]

That is correct. Foraminal narrowing = spinal stenosis.

[rkmcoder]

Spinal Stenosis is not Foraminal Narrowing. Spinal Stenosis is a narrowing of a spinal canal that compresses the Spinal Cord. Foraminal Narrowing is a stenosis of the vertebral foramen that compresses (encroaches on) a Nerve Root. In your ICD-9 Index, please look at COMPRESSION - NERVE - ROOT and you will find the codes you are looking for. Please GOOGLE 724.9 foraminal stenosis and you will find much supporting information.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

[gost]

Originally Posted by rkmcoder

Please GOOGLE 724.9 foraminal stenosis and you will find much supporting information.
rkmcoder@yahoo.com

Any time you search for exactly what you're looking for, you'll probably find it. That doesn't make it right. If you Google "723.0 foraminal stenosis" you get a lot of supporting documentation too. Spinal nerves typically become compressed in three locations: the central canal, where they leave the spinal column, and just distal of the column. The most common site is at the site where the nerves leave the spinal column, referred to as foraminal stenosis. Foraminal stenosis does cause compression of the nerve so I suppose it is up to you which code you use. Either is technicall correct. I prefer to code the cause, spinal stenosis (723.0) but I can see the logic in coding the effect, nerve compression (723.4). However, I personally would not code 723.4 unless the documentation specifically states nerve compression, radiculopathy, brachial neuritis or something similar. In that case, i would probably code both.

[rkmcoder]

Nerve Root Compression is the proper diagnosis when you see Foraminal Stenosis.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

[Tonyj]

Originally Posted by rkmcoder

Spinal Stenosis is not Foraminal Narrowing. Spinal Stenosis is a narrowing of a spinal canal that compresses the Spinal Cord. Foraminal Narrowing is a stenosis of the vertebral foramen that compresses (encroaches on) a Nerve Root. In your ICD-9 Index, please look at COMPRESSION - NERVE - ROOT and you will find the codes you are looking for. Please GOOGLE 724.9 foraminal stenosis and you will find much supporting information.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

I believe you are correct to a point. Foraminal narrowing isn't the same as spinal stenosis but 724.9 is referrable to the lower back. If you are referencing C3-C4 it may be more appropiate to use 723.8 Cervical syndrome NEC.
TonyJ

[rkmcoder]

(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

I see nothing in any description of 724.9 that indicates 'lower back', and I see nothing in any description of 723.8 that indicates 'stenosis' or 'compression'. Please share your documentation.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

[Tonyj]

Originally Posted by rkmcoder

(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

I see nothing in any description of 724.9 that indicates 'lower back', and I see nothing in any description of 723.8 that indicates 'stenosis' or 'compression'. Please share your documentation.

Richard Mann, your pain management coder
rkmcoder@yahoo.com

724.0 starts w/spinal stenosis other than cervical. All other codes beginning w/724 are basically specific to thoracic/lumbar/coccyx...
723.8 (other syndromes affecting cervical region).
Just my opinion. I'm far from being a guru.

Tonyj

[rkmcoder]

(These are my opinions and should not be construed as being the final authority. Other opinions may vary.)

I see your point, and it is a good one. Another way to look at it: 723 codes are 'neck' codes and 724 codes are 'back' codes. Following this logic, and I feel it is valid, then I would code 'cervical foraminal stenosis' as 723.9 (just to be disagreeable :>) ...

Richard Mann, your pain management coder
rkmcoder@yahoo.com