Neurosurgery Coding Alert

ICD-10 2024:

Update Includes New Dx Codes for Parkinson’s, Epilepsy

Chronic migraine with aura to be represented in 2024.

It’s that time of year again. The folks at ICD-10 have released their new code list for 2024, and coders now have to familiarize themselves with the new codes.

The lowdown: The ICD-10 2024 addendum includes about 500 new codes, with another 30 or so revised codes and some codes converted to parents. There’s plenty for neurosurgery coders to digest before the new codes become effective on Oct. 1, 2023.

Check out the codes you’ll want to learn most before ICD-10 2024 takes effect.

Check Out These New Code ‘Parents’

The first new codes we’ll cover come under already-existing codes that have been converted to parent codes. When a code is converted to parent code, it expands the coding possibilities under that particular diagnosis code by adding new codes with greater specificity below it. Check out these parent code conversions, along with their new code families:

Converted to Parent

  • G20 (Parkinson’s disease)

New Codes

  • G20.A (Parkinson’s disease without dyskinesia)
  • G20.A1 (Parkinson’s disease without dyskinesia, without mention of fluctuations)
  • G20.A2 (Parkinson’s disease without dyskinesia, with fluctuations)
  • G20.B (Parkinson’s disease with dyskinesia)
  • G20.B1 (Parkinson’s disease with dyskinesia, without mention of fluctuations)
  • G20.B2 (Parkinson’s disease with dyskinesia, with fluctuations)
  • G20.C (Parkinsonism, unspecified)

Analysis: Remarkably, G20 was the only code for Parkinson’s disease in the ICD-10 code book before 2024. These updates will make Parkinson’s coding more specific by adding information about dyskinesia and fluctuations.

According to Gregory Przybylski, MD, Chairman of Neuroscience at the New Jersey Neuroscience Institute, JFK University Medical Center in Edison, New Jersey, any expansion of the Parkinson’s codes is a positive.

“Greater specificity in Parkinson’s disease is helpful in tracking treatments of this condition. Given that Parkinson’s disease has several manifestations in a patient’s condition and function, greater granularity in the diagnosis codes will help track how the various manifestations of Parkinson’s disease responds to various treatments,” he says.

Converted to Parent

  • G37.8 (Other specified demyelinating diseases of central nervous system)

New Codes

  • G37.81 (Myelin oligodendrocyte glycoprotein antibody disease)
  • G37.89 (Other specified demyelinating diseases of central nervous system)

Analysis: This is a relatively minor change, but it will make reporting myelin oligodendrocyte glycoprotein antibody disease possible.

New Code Sets Added to Epilepsy, Migraine

In addition to the new parent codes, neurosurgery coders will want to note some completely new sets that will appear in ICD-10 2024.

New Codes

  • G40.C (Lafora progressive myoclonus epilepsy)
  • G40.C0 (Lafora progressive myoclonus epilepsy, not intractable)
  • G40.C01 (Lafora progressive myoclonus epilepsy, not intractable, with status epilepticus)
  • G40.C09 (Lafora progressive myoclonus epilepsy, not intractable, without status epilepticus)
  • G40.C1 (Lafora progressive myoclonus epilepsy, intractable)
  • G40.C11 (Lafora progressive myoclonus epilepsy, intractable, with status epilepticus)
  • G40.C19 (Lafora progressive myoclonus epilepsy, intractable, without status epilepticus)

Analysis: These additions provide another layer to the G40.- (Epilepsy and recurrent seizures) code group, which is already considerable. It represents a type of epilepsy that didn’t previously have specific codes; and these codes account for intractable/not intractable and with/without status epilepticus.

For those unfamiliar with the condition, Lafora progressive myoclonus epilepsy is a type of epilepsy characterized by seizures and progressive neurological deterioration. It is a rare genetic disorder that usually begins in adolescence and is caused by mutations in certain genes. The seizures in Lafora progressive myoclonus epilepsy are often myoclonic, which means they involve sudden, brief muscle jerks. Other symptoms may include cognitive decline, difficulty with coordination and balance, and visual hallucinations.

New Codes

  • G43.E (Chronic migraine with aura)
  • G43.E0 (Chronic migraine with aura, not intractable)
  • G43.E01 (Chronic migraine with aura, not intractable, with status migrainosus)
  • G43.E09 (Chronic migraine with aura, not intractable, without status migrainosus)
  • G43.E1 (Chronic migraine with aura, intractable)
  • G43.E11 (Chronic migraine with aura, intractable, with status migrainosus)
  • G43.E19 (Chronic migraine with aura, intractable, without status migrainosus)

Analysis: Much like the new epilepsy codes, the new migraine codes add another layer to the already deep field of G43.- (Migraine) codes. Before 2024, chronic migraine with aura did not have its own code set. In 2024, you’ll be able to code for chronic migraine with aura, and you can further specify that diagnosis by answering the intractable/not intractable and status migrainosus questions.

Remember, chronic migraine is a condition characterized by the presence of a headache on 15 or more days per month for at least three months, with at least eight of those headaches being migraines.

Also, migraine with aura refers to a set of neurological symptoms that some individuals experience before or during a migraine. These symptoms typically occur gradually and can last for a few minutes to an hour. Migraine aura can manifest as various sensory disturbances, such as visual changes (flashing lights, blind spots, zigzag lines), tingling or numbness in the face or limbs, difficulty speaking, or even temporary loss of vision.