Neurology & Pain Management Coding Alert

Prepare now for expanded choice related to radiculopathy.

Payers might have different diagnoses that they consider acceptable for supporting nerve conduction studies, but two common ones are 356.2 (Hereditary sensory neuropathy) or 724.4 (Thoracic or lumbosacral neuritis or radiculitis, unspecified).

You don’t have many “excludes” or other guidelines directing how you should report 356.2 or 724.4, although you should link an external cause code to 724.4, if applicable, to identify the cause of the musculoskeletal condition your physician is treating.

ICD-10 Keeps Neuropathy Switch Easy

Your code shift for 356.2 will be simple when ICD-10 takes effect in October 2014: just report G60.0 (Hereditary motor and sensory neuropathy). Pay attention to the conditions that G60.0 applies to and those that have their own separate diagnosis codes, however.   

For example, G60.0 will apply to hereditary motor and sensory neuropathy (types I-IV), Roussy-Levy syndrome, and peroneal muscular atrophy (axonal type) (hypertrophic type). But G60.0 excludes such common conditions as neuralgia NOS (M79.2), neuritis NOS (M79.2), peripheral neuritis in pregnancy (O26.82-), and radiculitis NOS (M54.10).

Watch for More Specific Radiculopathy Choices

The diagnosis switch-over gets more complicated for 724.4. The latest crosswalks include:

GEM

• M54.14 – Radiculopathy, thoracic region
• M54.15 – Radiculopathy, thoracolumbar region
• M54.16 – Radiculopathy, lumbar region
• M54.17 – Radiculopathy, lumbosacral region

Extended

• M51.14 – Intervertebral disc disorders with radiculopathy, thoracic region
• M51.15 – Intervertebral disc disorders with radiculopathy, thoracolumbar region
• M51.16 – Intervertebral disc disorders with radiculopathy, lumbar region
• M51.17 – Intervertebral disc disorders with radiculopathy, lumbosacral region.

Important: In order to correctly report the patient’s condition, your provider will need to document which spinal region is affected by the radiculopathy. Start encouraging them now to begin adding those details to their notes, if they aren’t already doing so.