Neurology & Pain Management Coding Alert

Question: A claim just crossed my desk with a diagnosis of Alice in Wonderland syndrome. Is this real? How do I code the condition? Virginia Subscriber Answer: Although it sounds like the patient (or your provider) has been spending too much time at the movies, Alice in Wonderland syndrome (AIWS) is real.But while the ICD-9 manual does contain a code for Alice in Wonderland Syndrome -- 293.89 (Other specified transient mental disorders due to conditions classified elsewhere; other) -- the manual also directs you to first code the associated physical or neurological conditions before the manifestation diagnosis code. Coding this condition also offers a good lesson: Certain conditions have both an underlying cause and multiple body system manifestations, and sorting out the primary diagnosis can be tricky. For such conditions, the ICD-9-CM has a specific way you should report the codes. Wherever such a combination exists, you should find a "use additional [...]