Neurology & Pain Management Coding Alert

Question: What is the difference between a schwannoma and neurofibroma? Oregon Subscriber Answer: Both terms refer to the two most common and typically benign nerve tumors. Both schwannomas and neurofibromas originate in the insulating covering of peripheral nerves called the nerve sheath. There is often confusion between the two tumors and sometimes a distinction can only be made by a pathologist with microscopic examination as the two tumors arise from different nerve cells. Schwannomas characteristically stay on the outside of the nerve but may push it aside or against a bony structure causing damage. Neurofibromas, in contrast, typically infiltrate the nerve and splay apart the individual nerve fibers. Unlike schwannomas, which are easily separated  from the host nerve with surgery, neurofibromas are more difficult to excise. Neurofibromas are often associated with neurofibromatosis (237.7x), but the tumors also occur in patients without the condition. It's often difficult to distinguish these tumors [...]