Neurosurgery Coding Alert

Hint: Schwannomatosis doesn’t cause hearing loss like NF2.

When your neurosurgeon documents a case of neurofibromatosis, you must pay attention to numerous details in the medical documentation, including which type of neurofibromatosis the patient has. And, since two types of neurofibromatosis may also be known by different names, you must know what the ICD-10 manual says about this diagnosis.

Read on to learn more.

First, Define Neurofibromatosis for Clarity

Question 1: What is neurofibromatosis?

Answer: When a patient has neurofibromatosis, he has a genetic disorder that causes tumors to form on nerve tissue. These tumors can develop anywhere in the patient’s nervous system, including his brain, spinal cord, and nerves.

You will see three different types of neurofibromatosis in the medical documentation when your neurosurgeon makes this diagnosis — neurofibromatosis Type 1, neurofibromatosis Type 2, and Schwannomatosis.

Report Q85.01 for Neurofibromatosis Type 1

Question 2: My neurosurgeon documented a case of neurofibromatosis Type 1 (NF1). Which ICD-10 code should I report for this condition?

Answer: You should report Q85.01 (Neurofibromatosis, type 1) for NF1.

Don’t miss: NF1 is also called von Recklinghausen’s disease. If you look at code Q85.01 (Neurofibromatosis, type 1), you will see that von Recklinghausen’s disease is an included condition for code Q85.01.

NF1 usually appears in childhood. “Common symptoms may be present at birth and are usually evident by age 10,” according to AHA ICD-10-CM Coding Clinic Vol. 27, No. 4. “They include multiple light-brown (café-au-lait) spots on the skin, tumors of the peripheral nerve, freckling in the armpit or groin, abnormal development of the spine, cardiovascular complications and learning disabilities. NF1 is progressive.”

Rely on This Code for Neurofibromatosis Type

Question 3: My neurosurgeon documented a diagnosis of neurofibromatosis Type 2. Which code should I report for this condition?

Answer: You should report Q85.02 (Neurofibromatosis, type 2) for neurofibromatosis Type 2 (NF2).

Don’t miss: When you look up Q85.02 in the ICD-10 manual, you will see that acoustic neurofibromatosis is an included condition for neurofibromatosis Type 2.

For NF2, the main complaint you should specifically look for in the clinical records is hearing loss. NF2 is characterized by bilateral acoustic neuromas. These are tumors of the vestibulocochlear nerve, which is the eighth cranial nerve.

Along with gradual hearing loss, other signs and symptoms of NF2 can include ringing in the ears, poor balance, and headaches.

Identify Q85.03 for Schwannomatosis

Question 4: Is Schwannomatosis a type of neurofibromatosis, and if so, which ICD-10 code should I report?

Answer: Yes. Schwannomatosis is the rarest type of neurofibromatosis. You should report Q85.03 (Schwannomatosis) for this condition. Patients usually see symptoms of this condition between the ages of 25 and 30.

Schwannomatosis defined: Schwannomatosis is a disorder characterized by multiple schwannomas, which are benign tumors involving the Schwann cells that produce the nerve sheath to provide insulation in the nerves. The schwannomas may be in the cranial, spinal, or peripheral nerves. You may also note that your surgeon documented segmental schwannomatosis. This term refers to schwannomas that are localized to a part of the body such as the leg or spine.

Don’t miss: Schwannomatosis usually doesn’t cause tumors to grow on hearing nerves, so patients with this condition don’t experience the hearing loss that patients with NF2 will have.