Know Shunt Malfunction Types to Master Coding
Question: Encounter notes indicate that the neurosurgeon saw a patient who was experiencing headache, vision changes, and memory problems. A week earlier, the surgeon inserted a ventricular-intracranial shunt to treat the patient’s normal-pressure hydrocephalus. The surgeon diagnoses “shunt malf.” What is the correct ICD-10-CM code for this condition? Idaho Subscriber Answer: The patient suffered a ventricular-intracranial shunt malfunction, but you’ll need some more information to choose the correct ICD-10-CM code for the condition. Do this: Go back and check the notes for more information on the type of malfunction. Then, choose one of the following ICD-10-CM codes: No matter which diagnosis code you choose, be sure to use an “X” as a 6th character placeholder and a “D” as the 7th character to indicate that this is a subsequent encounter for the shunt placement. So, if the patient suffered displacement of the shunt, you’d report T85.02XD (Displacement of ventricular intracranial (communicating) shunt, subsequent encounter). Also, remember to include a secondary diagnosis code of G91.2 ((Idiopathic) normal pressure hydrocephalus) to represent the patient’s hydrocephalus. Extra info: You should know the general symptoms of shunt malfunctions in particular patients so you aren’t caught off-guard when coding the claims. Here are some shunt malfunction symptoms broken up by patient type, according to Kalie Bothma, CPC, CEDC, CSAF, medical coder at Corewell Health: Chris Boucher, MS, CPC, Senior Development Editor, AAPC 
