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Neurology & Pain Management Coding Alert

Reader Questions:

333.1 Is Best Diagnosis for Rubral Tremor

Published on Wed Sep 12, 2007

Question: Which diagnosis should I report for a rubral tremor? New Mexico Subscriber Answer: Your best option is probably 333.1 (Essential and other specified forms of tremor). This condition -- also known as Holmes- tremor -- includes a combination of rest, postural and action tremors due to midbrain lesions in the vicinity of the red nucleus. Rubral tremors are irregular and slow-frequency (4.5 Hz). The patient might show signs of ataxia and weakness. The tremor is often most prominent when the patient is active or when he maintains a particular posture. Common causes include cerebrovascular accident and multiple sclerosis, with tremor onset and lesion occurrence possibly delaying for two weeks to two years.
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