Neurosurgery Coding Alert
7 Questions Guide Your Coding for Malignant Tumors in the Spinal Cord and Cauda Equina
Report C72.59 for malignant tumor in the Trochlear cranial nerve (IV). If you neurosurgeon treats malignant tumors in the spinal cord, cauda equina, spinal meninges, and the cranial nerves, you should check the medical documentation for specific details including which cranial nerve the tumor is located in. Read on to learn more. Pinpoint This Dx Code for Malignant Spinal Cord Tumors Question 1: What ICD-10-CM code should I report for a malignant tumor of the spinal cord? Answer: You just have one code choice for a malignant tumor of the spinal cord. In this case, you would report code C72.0 (Malignant neoplasm of spinal cord) for a malignant tumor of the spinal cord. Mark Down Malignant Spinal Cord Tumor Symptoms Question 2: What are some symptoms that patients who are diagnosed with a malignant tumor of the spinal cord may experience? Answer: Patients with a malignant tumor of the spinal cord may have back pain that slowly appears and gradually worsens, nighttime pain, headaches, generalized weakness, tingling, and a numbness or loss of sensation in their extremities, and paralysis. Understand Where Cauda Equina is Located Question 3: What ICD-10-CM code should I report for a malignant tumor of the cauda equina? Answer: For malignant neoplasms of the cauda equina, you would report C72.1 (Malignant neoplasm of cauda equina). Cauda equina defined: Cauda equina is the bundle of spinal nerves and spinal nerve roots that originate in the tip of the spinal cord called the conus. This bundle consists of nerve pairs that originate from the conus, usually between the first and second lumbar level extending to the fifth sacral level, and the coccygeal nerve. This bundle has both sensory and motor nerves and supplies the pelvic organs, perineum, and lower limbs. Notice Malignant Tumor of Cauda Equina Symptoms Question 4: What symptoms will patients who have been diagnosed with a malignant tumor of the cauda equina experience? Answer: Patients with a malignant tumor of the cauda equina may experience back pain, numbness, imbalance, general weakness, bladder impairment, and sometimes paraplegia. See ICD-10-CM Code for Malignant Tumor of Spinal Meninges Question 5: Which code should I report for malignant tumors in the meningeal coverings of the spinal cord? Answer: To report malignant tumor of spinal meninges, you would report C70.1 (Malignant neoplasm of spinal meninges). Don’t miss: The meninges are three membranes that enclose the brain, spinal cord, and nerve roots. If a patient has a malignant neoplasm on his spinal meninges, then the cancer is located on the membranes that cover his spinal cord and nerve roots. Identify Specific Cranial Nerve to Choose Appropriate Dx Code Question 6: Which ICD-10-CM codes should I report for malignant tumors in the cranial nerves? Answer: Coding for malignant tumors in the cranial nerves is a bit more complicated than reporting tumors in the spinal cord, cauda equina, and spinal meninges. First of all, you must identify which cranial nerve is involved. Then you must see if ICD-10-CM gives you a dedicated diagnosis code for the involved cranial nerve. Lastly, you must choose the code that corresponds with the appropriate side of the patient’s body that is affected. Your body has 12 cranial nerves. However, ICD-10-CM only offers specific codes for malignant tumors in the following cranial nerves: I (Olfactory), II (Optic), and VIII (Acoustic). For a malignant tumor of the olfactory nerve, you would report C72.2- (Malignant neoplasm of olfactory nerve). Your choices get more specific depending on the affected side. For a malignant tumor of the optic nerve, you would report C72.3- (Malignant neoplasm of optic nerve). You also have more specific choices, depending upon the affected side of the patient’s body. For a malignant tumor of the acoustic nerve, you would report C72.4- (Malignant neoplasm of acoustic nerve). You also have the following more specific choices: Neurosurgeon Documents Malignant Tumor in Trochlear Nerve? Do This Question 7: What happens if my neurosurgeon documents a malignant tumor in the Trochlear cranial nerve (IV). Answer: Your claims are not limited to only olfactory, optic, and acoustic cranial nerves. When your physician documents a malignant tumor in a cranial nerve other than these three nerves, you can report code C72.59 (Malignant neoplasm of other cranial nerves). 
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