Neurology & Pain Management Coding Alert

Watch terms and deficits to choose legitimate codes.Updated ICD-9 guidelines went into effect October 1, 2010, with three section changes affecting neurology coders. Not all 2011 ICD-9-CM books will include the updated guidelines because the books went to printers before the updated guidelines became available. Read on for the basic information your practice needs to know, however, then check out the full guidelines at www.cdc.gov/nchs/data/icd9/icdguide10.pdf. Check Your TerminologyPatients -- and practitioners -- sometimes use the terms "stroke" and "CVA" (cerebrovascular accident) interchangeably to refer to a cerebral infarction. The terms "stroke," "CVA," and "cerebral infarction NOS" each fall under diagnosis 434.91 (Cerebral artery occlusion, unspecified; with cerebral infarction). The updated guidelines add, "Additional code(s) should be assigned for any neurological deficits with the acute CVA, regardless of whether or not the neurologic defect resolves prior to discharge."Example: Some neurologic deficits your neurologist might document in addition to the acute CVA include [...]